Motor Nerve Transfers to Restore Extrinsic Median Nerve Function: Case Report |
| |
Authors: | Eugene C Hsiao Ida K Fox Thomas H Tung Susan E Mackinnon |
| |
Institution: | (1) Department of Surgery, Division of Plastic and Reconstructive Surgery, School of Medicine, Washington University, 660 S Euclid, Campus Box 8238, Saint Louis, MO 63110, USA |
| |
Abstract: | Active pronation is important for many activities of daily living. Loss of median nerve function including pronation is a
rare sequela of humerus fracture. Tendon transfers to restore pronation are reserved for the obstetrical brachial plexus palsy
patient. Transfer of expendable motor nerves is a treatment modality that can be used to restore active pronation. Nerve transfers
are advantageous in that they do not require prolonged immobilization postoperatively, avoid operating within the zone of
injury, reinnervate muscles in their native location prior to degeneration of the motor end plates, and result in minimal
donor deficit. We report a case of lost median nerve function after a humerus fracture. Pronation was restored with transfer
of the extensor carpi radialis brevis branch of the radial nerve to the pronator teres branch of the median nerve. Anterior
interosseous nerve function was restored with transfer of the supinator branch to the anterior interosseous nerve. Clinically
evident motor function was seen at 4 months postoperatively and continued to improve for the following 18 months. The patient
has 4+/5 pronator teres, 4+/5 flexor pollicis longus, and 4−/5 index finger flexor digitorum profundus function. The transfer
of the extensor carpi radialis brevis branch of the radial nerve to the pronator teres and supinator branch of the radial
nerve to the anterior interosseous nerve is a novel, previously unreported method to restore extrinsic median nerve function. |
| |
Keywords: | Nerve transfers Pronation Nerve injury Median nerve |
本文献已被 PubMed SpringerLink 等数据库收录! |
|