Triple transferencia tendinosa en la parálisis radial alta. A propósito de un caso / Triple tendinous transference in high radial paralysis. Apropos of a case

RESUMEN La parálisis del nervio radial producida por lesiones a nivel del brazo es considerada una parálisis alta, y se caracteriza por presentar la muñeca y los dedos flexionados y el pulgar en aducción con imposibilidad para la extensión de los mismos (muñeca y dedos). Todos los autores coinciden en que, para la extensión de la muñeca, el músculo de elección a transferir es el pronador redondo para el segundo radial. Sin embargo, hay diversidad de criterios sobre la utilización del palmar mayor o del cubital anterior para el extensor común de los dedos, y del palmar menor para el extensor largo del pulgar. Se presentó el caso de un paciente de 31 años de edad, con antecedente de accidente de tránsito y diagnóstico de parálisis radial alta de 18 meses de evolución, en el que se decide tratamiento quirúrgico utilizando el músculo cubital anterior después de una rehabilitación exitosa, obteniéndose excelentes resultados (AU).

ABSTRACT The radial nerve paralysis produced by lesions at the level of the arm is considered a high paralysis, and is characterized by presenting the wrist and fingers flexed and the thumb in adduction with impossibility of extending them (wrist and fingers). All consulted authors agree that, for wrist extension, the elective muscle to transfer is the round pronator for the second radial. However, there are different criteria on the use of the palmar major or anterior ulnar for the common finger extender, and the palmar minor for the long thumb extender. We presented the case of a 31-year-old patient, with a history of traffic accident and diagnosis of 18-month high radial paralysis, in which surgical treatment using the anterior ulnar muscle after a successful rehabilitation was decided, obtaining excellent results (AU).

Simultaneous tendon transfer and autogenous augmentation of the first web space of the hand with intrinsic paralysis

Simultaneous tendon transfer and dermofat graft augmentation of the first web space of the hand with intrinsic paralysis is described. Fifty per cent over-correction of the web space volume is recommended in anticipation of postoperative graft resorption. Other techniques of fat auto-transplantation are discussed.

Desenvolvimento de um aparelho portátil de movimentaçäo contínua passiva para a mäo / Development of the portatil equipment of continuous passive motions for hand

A movimentação contínua passiva (MCP) visa uma movimentação lenta. Ela é realizada através de aparelhos adaptados para cada articulação. Empregado precocemente, previne sequelas e deformidades, diminuindo o tempo de tratamento, com consequente diminuição dos custos e com melhores resultados funcionais. O objetivo deste trabalho é desenvolver, com tecnologia nacional, um dispositivo de MCP para a mão, baseado em modelos de aparelhos estrangeiros. O aparelho deve ser portátil e de simples manuseio

Abstract - Continuous Passive Motion (CPM) units promote gentle passive motion to the joints. Different models are used for different joints. CPM helps mantain the potential for motion by moving tissues while healing occurs, preventing adhesion and deformities. The goal ofthis research is to develop national technology in this field creating a CPM unit for the hand

Opponensplasty by extensor indicis and flexor digitorium superficialis tendon transfer

From 1977 to 1988, 166 patients with median nerve paralysis of varied aetiology underwent opponensplasty. In 50 of these the extensor indicis was used, and in 116 the flexor digitorum superficialis of the ring finger. An analysis of these hands showed that the EI opponensplasty was best in supple hands and FDS opponensplasty was more suitable for less pliable hands. There were fewer complications seen after FDS opponensplasty if the detachment of the donor tendon was done through a volar oblique incision rather than the conventional lateral incision.

Partial flexor carpi radialis many-tailed transfer for correction of claw fingers.

The method described shows, that correction of claw fingers is possible using a portion of the flexor carpi radialis as motor. Usually, this method is indicated, whenever it is desired to do a Palmaris Longus many-tailed transfer in the absence of palmaris longus (e.g. for correction of hyper-mobile claw fingers).