Non-recoverable low radial nerve palsy and the outcomes of Smith's procedure of tendon transfer

ABSTRACT

Background: In the procedure of tendon transfer to treat low radial nerve palsy, recovering movement amplitude for toes is not difficult. It is more important to select the appropriate motive muscle. Previously, pillar muscle was commonly used as motivation for stretching fingers, but many authors opposed this because it\u2019s affecting the function of the hand. Objectives: To evaluate the clinical features of low radial nerve palsy and the outcomes of the treatment of non-recoverable low radial nerve palsy by Smith's procedure of tendon transfer. Subjects and methods: 36 patients suffering from irreversible low radial nerve palsy were treated by Smith's procedure of tendon transfer from Jan 2000 to Jan 2008. Mean follow-up was 23 months. Outcomes assessment was based on Tajima's criteria. Results: All 30 patients were satisfied with the operation and were greatly improved both their functional and aesthetic aspects. In term of biomechanics, the Flexor Carpi Radialis (FCR) is more suitable for reconstruction of the Extensor Digitorum Communis (EDC) in comparison with the flexor carpi ulnaris (FeU) or the power density spectrum. The patients showed good movements of the wrist and fingers/ the thumb moved independently with satisfactory extension and abduction/ the grip strength was rapidly improving. Conclusions: The use of the FCR for reconstruction of the EDC is a suitable choice and Smith's procedure of tendon transfer is a good procedure for the treatment of irreversible radial nerve palsy.