TY - JOUR
T1 - Median to radial nerve transfer after traumatic radial nerve avulsion in a pediatric patient
AU - Larson, Ellen L.
AU - Santosa, Katherine B.
AU - Mackinnon, Susan E.
AU - Snyder-Warwick, Alison K.
N1 - Funding Information:
Research support in this publication was by the National Institute of Neurological Disorders and Stroke (NINDS) of the National Institutes of Health under Award Numbers F32NS098561 (to K.B.S.) and K08NS096232 (to A.K.S.W.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health (NIH).
Publisher Copyright:
© AANS 2019, except where prohibited by US copyright law
PY - 2019
Y1 - 2019
N2 - This case report describes an isolated radial nerve avulsion in a pediatric patient, treated by combination sensory and motor median to radial nerve transfers. After traumatic avulsion of the proximal radial nerve, a 12-year-old male patient underwent end-to-end transfer of median nerve branches to flexor carpi radialis and flexor digitorum superficialis to the posterior interosseous nerve and extensor carpi radialis nerve, respectively. He underwent end-to-side sensory transfer of the superficial radial sensory to the median sensory nerve. Pronator teres to extensor carpi radialis brevis tendon transfer was simultaneously performed to power short-term wrist extension. Within months after surgery, the patient had regained 9–10/10 sensation in the hand and forearm. In the following months and years, he regained dexterity, independent fine-finger and thumb motions, and 4–5/5 strength in all extensors except the abductor pollicis longus muscle. He grew 25 cm without extremity deformity or need for secondary orthopedic procedures. In appropriate adult and pediatric patients with proximal radial nerve injuries, nerve transfers have advantages over tendon transfers, including restored independent fine finger motions, regained sensation, and reinnervation of multiple muscle groups with minimal donor sacrifice.
AB - This case report describes an isolated radial nerve avulsion in a pediatric patient, treated by combination sensory and motor median to radial nerve transfers. After traumatic avulsion of the proximal radial nerve, a 12-year-old male patient underwent end-to-end transfer of median nerve branches to flexor carpi radialis and flexor digitorum superficialis to the posterior interosseous nerve and extensor carpi radialis nerve, respectively. He underwent end-to-side sensory transfer of the superficial radial sensory to the median sensory nerve. Pronator teres to extensor carpi radialis brevis tendon transfer was simultaneously performed to power short-term wrist extension. Within months after surgery, the patient had regained 9–10/10 sensation in the hand and forearm. In the following months and years, he regained dexterity, independent fine-finger and thumb motions, and 4–5/5 strength in all extensors except the abductor pollicis longus muscle. He grew 25 cm without extremity deformity or need for secondary orthopedic procedures. In appropriate adult and pediatric patients with proximal radial nerve injuries, nerve transfers have advantages over tendon transfers, including restored independent fine finger motions, regained sensation, and reinnervation of multiple muscle groups with minimal donor sacrifice.
KW - Median to radial nerve transfer
KW - Pediatrics
KW - Peripheral nerve
KW - Radial nerve injury
UR - http://www.scopus.com/inward/record.url?scp=85073643763&partnerID=8YFLogxK
U2 - 10.3171/2019.3.PEDS18550
DO - 10.3171/2019.3.PEDS18550
M3 - Article
C2 - 31151095
AN - SCOPUS:85073643763
SN - 1933-0707
VL - 24
SP - 209
EP - 214
JO - Journal of Neurosurgery: Pediatrics
JF - Journal of Neurosurgery: Pediatrics
IS - 2
ER -