Transfer of Supinator Motor Branches to the Posterior Interosseous Nerve to Reconstruct Thumb and Finger Extension in Tetraplegia: Case Report

Bertelli, Jayme Augusto; Tacca, Cristiano Paulo; Ghizoni, Marcos Flávio; Kechele, Paulo Roberto; Santos, Marcos

doi:10.1016/j.jhsa.2010.07.012

Cited by 82 publications

(46 citation statements)

References 8 publications

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“…In patients with C7-T1 root avulsion, thumb and finger extension was reconstructed by transferring the nerve to the supinator to the posterior interosseous nerve (PIN), as reported before. 5,6 In one of these patients, with elbow extension paralysis, the posterior division of the axillary nerve was transferred to triceps branches, as reported previously. 7 In patients with high ulnar and median nerve injuries, sensation in the median nerve territory was reconstructed by transferring dorsal radial nerve sensory branches to palmar nerves of the index and thumb, as described before.…”

Section: Additional Proceduresmentioning

confidence: 74%

Transfer of the Radial Nerve Branch to the Extensor Carpi Radialis Brevis to the Anterior Interosseous Nerve to Reconstruct Thumb and Finger Flexion

Bertelli

2015

The Journal of Hand Surgery

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Section: Additional Proceduresmentioning

confidence: 74%

Transfer of the Radial Nerve Branch to the Extensor Carpi Radialis Brevis to the Anterior Interosseous Nerve to Reconstruct Thumb and Finger Flexion

Bertelli

2015

The Journal of Hand Surgery

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“…18 The high number of peripheral-type injuries we observed reinforces our initial belief that patients with tetraplegia should undergo operations within 1 year of their trauma. [3][4][5][6] Of interest was the potential for improvement, even after 18 months of peripheral palsy, following a distal nerve transfer. We have deemed palsy to be of peripheral origin when intraoperative electrical stimulation of a given motor branch produced no muscle contraction.…”

Section: Discussionmentioning

confidence: 99%

“…Details of the surgical technique can be obtained elsewhere. 3,5 In 1 patient, an anterior elbow approach was used.…”

Section: Thumb and Finger Extension Reconstructionmentioning

confidence: 99%

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Nerve transfers for elbow and finger extension reconstruction in midcervical spinal cord injuries

Bertelli¹,

Ghizoni²

2015

JNS

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OBJECT The objective of this study was to report the results of elbow, thumb, and finger extension reconstruction via nerve transfer in midcervical spinal cord injuries. METHODS Thirteen upper limbs from 7 patients with tetraplegia, with an average age of 26 years, were operated on an average of 7 months after a spinal cord injury. The posterior division of the axillary nerve was used to reinnervate the triceps long and upper medial head motor branches in 9 upper limbs. Both the posterior division and the branch to the middle deltoid were used in 2 upper limbs, and the anterior division of the axillary nerve in the final 2 limbs. For thumb and finger extension reconstruction, the nerve to the supinator was transferred to the posterior interosseous nerve. RESULTS In 22 of the 27 recipient nerves, a peripheral type of palsy with muscle denervation was identified. At an average of 19 months follow-up, elbow strength scored M4 in 11 upper limbs and M3 in 2, according to the British Medical Research Council scale. Thumb extension scored M4 in 8 upper limbs and scored M3 in 4. Finger extension scored M4 in 12 hands. No donor-site deficits were reported or observed. CONCLUSIONS Nerve transfers are effective at restoring elbow, thumb, and finger extension in patients with a midcervical spinal cord injury, which occurs in the majority of patients with a peripheral type of palsy with muscle denervation in their upper limbs. Efforts should be made to perform operations in these patients within 12 months of injury.

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“…The limitations of tendon transfers include limited tendon/muscle donors and a long duration of postoperative immobilization. Newer treatment options such as nerve transfer surgery [1][2][3][5][6][7][8][9][10][11][12][13] could improve eligibility or desirability for reconstructive surgery.…”

Section: Introductionmentioning

confidence: 99%

The Use of Nerve Transfers to Restore Upper Extremity Function in Cervical Spinal Cord Injury

Fox

Novak

Krauss

et al. 2018

PM&R

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Transfer of Supinator Motor Branches to the Posterior Interosseous Nerve to Reconstruct Thumb and Finger Extension in Tetraplegia: Case Report

Cited by 82 publications

References 8 publications

Transfer of the Radial Nerve Branch to the Extensor Carpi Radialis Brevis to the Anterior Interosseous Nerve to Reconstruct Thumb and Finger Flexion

Transfer of the Radial Nerve Branch to the Extensor Carpi Radialis Brevis to the Anterior Interosseous Nerve to Reconstruct Thumb and Finger Flexion

Nerve transfers for elbow and finger extension reconstruction in midcervical spinal cord injuries

The Use of Nerve Transfers to Restore Upper Extremity Function in Cervical Spinal Cord Injury

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