Brachioradialis to flexor digitorum profundus tendon transfer to restore finger flexion

Introduction: The main deformity following an adult lower brachial plexus injury is the loss of finger flexion. Distal nerve transfers have been used to restore finger and thumb flexion followed by tendon transfers for intrinsic replacement for opening of the fingers. When patients present beyond 6...

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Main Authors: R. Srikanth, Koteswara Rao Rayidi, Subha Kakumanu
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2018-05-01
Series:Indian Journal of Plastic Surgery
Subjects:
Online Access:http://www.thieme-connect.de/DOI/DOI?10.4103/ijps.IJPS_7_18
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author R. Srikanth
Koteswara Rao Rayidi
Subha Kakumanu
author_facet R. Srikanth
Koteswara Rao Rayidi
Subha Kakumanu
author_sort R. Srikanth
collection DOAJ
description Introduction: The main deformity following an adult lower brachial plexus injury is the loss of finger flexion. Distal nerve transfers have been used to restore finger and thumb flexion followed by tendon transfers for intrinsic replacement for opening of the fingers. When patients present beyond 6 months, only tendon transfers are applicable. Since the brachioradialis (BR) is always spared in such injuries, it is the ideal muscle to provide finger flexion. Wrist extensor power may not be normal for the use of the radial wrist extensor to serve as donor. BR to FDP transfer provides reasonable flexion range and an acceptable hand function to permit activities of daily living, when associated with ancillary procedures like opponensplasty, PIPJ arthrodesis. Materials and Methods: Eleven patients underwent a BR to FDP tendon transfer between January 2013 and January 2017 of which eight patients came for follow-up. Results: Four of the eight patients got a functionally useful hand to carry out activities of daily living with hook grip, span grasp, key pinch, chuck grip and pulp pinch. These patients also underwent simultaneous or secondary ancillary procedures. Four of the patients need secondary procedures to further improve functionality of the hand inspite of having a flexion range. Conclusion: The BR is an effective donor in providing adequate range and power of finger flexion in lower plexus injuries.
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spelling doaj-art-b67c5de3c52a4bd7bd967da048ca6dd52025-08-20T03:20:55ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Plastic Surgery0970-03581998-376X2018-05-01510212313010.4103/ijps.IJPS_7_18Brachioradialis to flexor digitorum profundus tendon transfer to restore finger flexionR. Srikanth0Koteswara Rao Rayidi1Subha Kakumanu2Department of Plastic and Reconstructive Surgery, Nizams Institute of Medical Sciences, Hyderabad, Telangana, IndiaDepartment of Plastic and Reconstructive Surgery, Nizams Institute of Medical Sciences, Hyderabad, Telangana, IndiaDepartment of Plastic and Reconstructive Surgery, Nizams Institute of Medical Sciences, Hyderabad, Telangana, IndiaIntroduction: The main deformity following an adult lower brachial plexus injury is the loss of finger flexion. Distal nerve transfers have been used to restore finger and thumb flexion followed by tendon transfers for intrinsic replacement for opening of the fingers. When patients present beyond 6 months, only tendon transfers are applicable. Since the brachioradialis (BR) is always spared in such injuries, it is the ideal muscle to provide finger flexion. Wrist extensor power may not be normal for the use of the radial wrist extensor to serve as donor. BR to FDP transfer provides reasonable flexion range and an acceptable hand function to permit activities of daily living, when associated with ancillary procedures like opponensplasty, PIPJ arthrodesis. Materials and Methods: Eleven patients underwent a BR to FDP tendon transfer between January 2013 and January 2017 of which eight patients came for follow-up. Results: Four of the eight patients got a functionally useful hand to carry out activities of daily living with hook grip, span grasp, key pinch, chuck grip and pulp pinch. These patients also underwent simultaneous or secondary ancillary procedures. Four of the patients need secondary procedures to further improve functionality of the hand inspite of having a flexion range. Conclusion: The BR is an effective donor in providing adequate range and power of finger flexion in lower plexus injuries.http://www.thieme-connect.de/DOI/DOI?10.4103/ijps.IJPS_7_18brachial plexus injurybrachioradialisfinger flexionflexor digitorum profundustendon transfer
spellingShingle R. Srikanth
Koteswara Rao Rayidi
Subha Kakumanu
Brachioradialis to flexor digitorum profundus tendon transfer to restore finger flexion
Indian Journal of Plastic Surgery
brachial plexus injury
brachioradialis
finger flexion
flexor digitorum profundus
tendon transfer
title Brachioradialis to flexor digitorum profundus tendon transfer to restore finger flexion
title_full Brachioradialis to flexor digitorum profundus tendon transfer to restore finger flexion
title_fullStr Brachioradialis to flexor digitorum profundus tendon transfer to restore finger flexion
title_full_unstemmed Brachioradialis to flexor digitorum profundus tendon transfer to restore finger flexion
title_short Brachioradialis to flexor digitorum profundus tendon transfer to restore finger flexion
title_sort brachioradialis to flexor digitorum profundus tendon transfer to restore finger flexion
topic brachial plexus injury
brachioradialis
finger flexion
flexor digitorum profundus
tendon transfer
url http://www.thieme-connect.de/DOI/DOI?10.4103/ijps.IJPS_7_18
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AT koteswararaorayidi brachioradialistoflexordigitorumprofundustendontransfertorestorefingerflexion
AT subhakakumanu brachioradialistoflexordigitorumprofundustendontransfertorestorefingerflexion