Post Operative Physiotherapy for Pronator Teres Tendon Transfer

Original Editor - Tanvi Korba

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Top Contributors - Tanvi Korba and Kim Jackson  

Introduction[edit | edit source]

Proximal radial nerve injuries are seen mainly in patients with humeral shaft fractures[1]. [1] Tendon and nerve transfers are utilized if the Functional recovery is not observed after primary nerve repair. This surgical option is available for reconstruction of the wrist, thumb, and finger extension. The motor branch of the flexor digitorum superficialis (FDS) is used for the motor branch of the extensor carpi radialis brevis (ECRB). It is mainly used for a synergistic effect. The FDS function gets affected if the only branch of the FDS nerve is cut off. In such case scenarios, pronator teres (PT) nerve transfer to the extensor carpi radialis longus (ECRL) nerve is preferred to achieve and restore wrist extension[2]. [4]. For wrist extension reconstruction, the ECRB muscle is preferred over the ECRL due to ECRB muscle’s central location. That provides better-balanced radio-ulnar deviation during wrist extension[3][4][5]. [5–7) Outcomes of tendon transfer are considered favorable when patients achieve good wrist extension, finger extension, thumb extension, and hand grip. 3.

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References[edit | edit source]

  1. Ekholm R, Ponzer S, Törnkvist H, Adami J, Tidermark J. The Holstein-Lewis humeral shaft fracture: aspects of radial nerve injury, primary treatment, and outcome. Journal of orthopaedic trauma. 2008 Nov 1;22(10):693-7.
  2. García-López A, Navarro R, Martinez F, Rojas A. Nerve transfers from branches to the flexor carpi radialis and pronator teres to reconstruct the radial nerve. The Journal of Hand Surgery. 2014 Jan 1;39(1):50-6.
  3. Sammer DM, Chung KC. Tendon transfers part I: principles of transfer and transfers for radial nerve palsy. Plastic and reconstructive surgery. 2009 May;123(5):169e.
  4. Moussavi AA, Saied A, Karbalaeikhani A. Outcome of tendon transfer for radial nerve paralysis: Comparison of three methods. Indian journal of orthopaedics. 2011 Dec;45:558-62.
  5. Bertelli JA, Tacca CP, Duarte EC, Ghizoni MF, Duarte H. Transfer of the pronator quadratus motor branch for wrist extension reconstruction in brachial plexus palsy. Plastic and reconstructive surgery. 2012 Dec 1;130(6):1269-78.