The results of tendon transfers for high radial nerve palsy are good. there is growing interest in nerve transfer reconstruction due to the perceived digit extension independence and improved wrist flexion that is not possible with tendon transfers. the recovery is longer and patients will often get frustrated by the duration of the rehabilitation.
Do you recommend tendon transfers, nerve transfers or a hybrid where tenodesis can be achieved for digit extension with a pronator teres to extensor carpi radials braves tendon transfer and then FCR and Pl fascicles transferred at the same time to the posterior interosseous nerve through an anterior approach.
I have started to use this hybrid technique in selected patients where the independence of digit extension and the full wrist flexion is essential.
There is an article in this week’s JHS(Eur) by a senior author about his experience with tendon transfers. He believes that tendon transfers are the gold standard and that there needs to be more evidence for the benefit of nerve transfers.
Radial nerve has often surprised me with its recovery. However, doing an early tendon transfer should be okay as long as we do it end to side.
Have no experience in nerve transfers for high radial nerve injuries.
Dom, what has your results been?