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. 2024 Feb 22:16:94033.
doi: 10.52965/001c.94033. eCollection 2024.

TREATMENT OF IRRECOVERABLE RADIAL NERVE PALSY USING THE MODIFIED MERLE D'AUBIGNÉ TENDON TRANSFER METHOD

Tuong Trong Mai  1 , Vinh Quang Nguyen  1 , Phi Duong Nguyễn  2
Affiliations

TREATMENT OF IRRECOVERABLE RADIAL NERVE PALSY USING THE MODIFIED MERLE D'AUBIGNÉ TENDON TRANSFER METHOD

Tuong Trong Mai et al. Orthop Rev (Pavia). .

Abstract

Background: Irrecoverable radial nerve palsy (RNP) leads to the inability to extend the wrist and fingers and significant reduction in grip strength. The aim was to assess the outcomes of treating non-recovering motor RNP using the modified Merle d'Aubigné tendon transfer method.

Materials and methods: A descriptive prospective study involved 33 patients between January 2017 and March 2019.

Results: Males constituted the majority (32/33 cases, 97%). The ratio of radial nerve and posterior interosseous nerve injuries was nearly equivalent (16/17). The mean extension range of the wrist was 48.6° ± 14.9° during finger extension and 30.9° ± 14.4° during finger flexion. The mean flexion range of the wrist was 34.8° ± 15.8° during finger extension and 42.6° ± 14.8° during finger flexion. 93.9% of patients achieved full finger extension when the wrist joint was extended beyond 10°. The mean angulation range of the index finger was 55.3° ± 7.4°. The Kapanji score achieved was 8.4 ± 1.2. The achieved grip strength was 65.4% compared to the unaffected side. The surgery did not induce radial deviation deformities of the wrist joint. 32/33 patients were satisfied with the surgical outcomes. 31/33 patients returned to their previous professions. 93.9% of patients achieved very good and good results, while 6.1% achieved fair results.

Conclusion: Treating irrecoverable radial nerve palsy using the modified Merle d'Aubigné tendon transfer method yields very good results. The utilization of the pronator teres for wrist extensor transfer and the flexor carpi radialis for finger extensor transfer is appropriate and contributes to limiting wrist joint radial deviation deformities. This modified technique has been researched and recommended by various authors worldwide.

Keywords: posterior interosseous nerve palsy; radial nerve palsy; tendon transfer.

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Figures

Figure 1.
Figure 1.. After 7 months of surgery

  1. Wrist extend when MCP flex

  2. Wrist extend when MCP extend

  3. Wrist flex when MCP extend

  4. Wrist flex when MCP extend

  5. Adduct and extend the thumb

  6. Kapanji: 7.

See this image and copyright information in PMC

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References

    1. Apparent weakness of median and ulnar motors in radial nerve palsy. Labosky David A., Waggy Carol A. Jul;1986 The Journal of Hand Surgery. 11(4):528–533. doi: 10.1016/s0363-5023(86)80191-5. doi: 10.1016/s0363-5023(86)80191-5. - DOI - DOI - PubMed
    1. Cotation clinique de l'opposition et de la contre-opposition du pouce [Clinical test of apposition and counter-apposition of the thumb] Kapandji A. Jan;1986 Annales de Chirurgie de la Main. 5(1):67–73. doi: 10.1016/s0753-9053(86)80053-9. doi: 10.1016/s0753-9053(86)80053-9. - DOI - DOI - PubMed
    1. Radial Nerve Tendon Transfers. Cheah Andre Eu-Jin, Etcheson Jennifer, Yao Jeffrey. Aug;2016 Hand Clinics. 32(3):323–338. doi: 10.1016/j.hcl.2016.03.003. doi: 10.1016/j.hcl.2016.03.003. - DOI - DOI - PubMed
    1. Mauck B.M. Paralytic hand. Campbell's Operative Orthopaedics;
    1. Principles of tendon transfers. Douglas M.S. 2014Grabb and Smith's Plastic Surgery. :1912–937.