Publicado el 3/10/2014
Median (FCR/FDS) to Radial (PIN/ECRB) Nerve Transfers with PT to ECRB Tendon Transfer
Standard Edition (140820.140820)
Radial nerve palsy is a debilitating nerve injury that results in lost of wrist and finger extension, which classically presents as wrist drop. The two reconstructive options for managing this injury are tendon transfers and nerve transfers, each with their advantages and disadvantages. Nerve transfers are able to provide independent finger extension, however there is an associated prolonged recovery period in comparison to tendon transfers for radial nerve palsy. Electing the appropriate surgical management depends on the patient’s demands and needs. Nerve transfers for radial nerve palsy includes two transfers: (1) FCR to PIN and (2) FDS to ECRB. The tendon transfer for wrist extension can be elected for an early outcome and includes the transfer of the pronator teres to ECRB tendon. In this case, the patient presented three months following a severe MVC and suffered a radial nerve transection associated with a humeral facture. Due to the patient’s needs, the median to radial nerve transfers were elected with the pronator teres to ECRB tendon transfer. To restore radial nerve sensation, an end-to-side nerve transfer was additionally performed and included the radial sensory nerve end-to-side into the sensory component of the median nerve.
Table of Contents (Standard)
00:20 Orientation / Incision / Exposure
01:43 Identification and Distal Exposure of the Pronator Teres Tendon
03:48 Releasing and Elevating the Pronator Teres Tendon
05:47 Proximal Exposure of the Median Nerve
06:35 Dissection Lateral to the Pronator Teres
07:44 Identifying and Stimulation of the Median Nerve and Donor Nerve Branches
09:13 Proximal Exposure of the Radial Nerve
09:59 Dividing the Leash of Henry and Leading-edges of ECRB and Supinator
11:59 Identifying the Radial Nerve and Recipient Nerve Branches
12:06 Proximal Division of the Recipient Radial Nerve Branches
12:40 Removing the Supinator Nerve from the Posterior Interosseous Nerve
12:55 Proximal Division of the Recipient Superficial Branch of Radial Nerve
13:19 Distal Division of the Donor Median Nerve Branches
15:09 Median to Radial Nerve Transfers with End-to-side Radial Sensory Nerve Transfer
15:30 Releasing the Brachioradialis Tendon and Superficial Branch of Radial Nerve
15:54 Pronator Teres to ECRB Tendon Transfer
Narration: Susan E. Mackinnon
Videography: Andrew Yee
Terms of Use and Private Policy: nervesurgery.wustl.edu/pages/termsofuse.
Standard Edition (140820.140820)
Radial nerve palsy is a debilitating nerve injury that results in lost of wrist and finger extension, which classically presents as wrist drop. The two reconstructive options for managing this injury are tendon transfers and nerve transfers, each with their advantages and disadvantages. Nerve transfers are able to provide independent finger extension, however there is an associated prolonged recovery period in comparison to tendon transfers for radial nerve palsy. Electing the appropriate surgical management depends on the patient’s demands and needs. Nerve transfers for radial nerve palsy includes two transfers: (1) FCR to PIN and (2) FDS to ECRB. The tendon transfer for wrist extension can be elected for an early outcome and includes the transfer of the pronator teres to ECRB tendon. In this case, the patient presented three months following a severe MVC and suffered a radial nerve transection associated with a humeral facture. Due to the patient’s needs, the median to radial nerve transfers were elected with the pronator teres to ECRB tendon transfer. To restore radial nerve sensation, an end-to-side nerve transfer was additionally performed and included the radial sensory nerve end-to-side into the sensory component of the median nerve.
Table of Contents (Standard)
00:20 Orientation / Incision / Exposure
01:43 Identification and Distal Exposure of the Pronator Teres Tendon
03:48 Releasing and Elevating the Pronator Teres Tendon
05:47 Proximal Exposure of the Median Nerve
06:35 Dissection Lateral to the Pronator Teres
07:44 Identifying and Stimulation of the Median Nerve and Donor Nerve Branches
09:13 Proximal Exposure of the Radial Nerve
09:59 Dividing the Leash of Henry and Leading-edges of ECRB and Supinator
11:59 Identifying the Radial Nerve and Recipient Nerve Branches
12:06 Proximal Division of the Recipient Radial Nerve Branches
12:40 Removing the Supinator Nerve from the Posterior Interosseous Nerve
12:55 Proximal Division of the Recipient Superficial Branch of Radial Nerve
13:19 Distal Division of the Donor Median Nerve Branches
15:09 Median to Radial Nerve Transfers with End-to-side Radial Sensory Nerve Transfer
15:30 Releasing the Brachioradialis Tendon and Superficial Branch of Radial Nerve
15:54 Pronator Teres to ECRB Tendon Transfer
Narration: Susan E. Mackinnon
Videography: Andrew Yee
Terms of Use and Private Policy: nervesurgery.wustl.edu/pages/termsofuse.
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