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Maintaining full range of elbow, wrist motion a key outcome of radial nerve palsy treatment
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The radial nerve, a major upper limb nerve, is injured in conjunction with a humeral shaft fracture in 2% to 17% of cases. When that or another trauma to the radial nerve occurred, investigators of this study noted results with nonoperative treatment can be satisfactory.
However, they said there are a variety of surgical options to consider when it appears there is no improvement with conservative care, such as direct nerve repair or grafting, the Merle d’Aubigné procedure or functional muscle transfer.
“Conservative treatment certainly has a role, and one of the most important aspects of this treatment is to maintain a full passive range of motion in all the affected joints,” Marko Bumbasirevic, MD, PhD, of Belgrade, Serbia, and colleagues wrote.
Because several surgical options are described in the literature for tendon transfer surgery, the investigators recommended in their review study that the joint(s) affected attain good passive mobility prior to any type of tendon transfer procedure. They also suggested selecting donor muscles from an area of the body not affected by the nerve palsy pathology and testing donor muscles for strength prior to surgery.
Tendon transfer is also indicated for long-standing palsies or irreparable palsies, mostly so patient can regain hand function, they noted.
“New frontiers in nerve regeneration with stem cells have yielded preliminarily promising results, and future developments in this field are anticipated,” Bumbasirevic and colleagues wrote. – by Susan M. Rapp
Disclosure: Bumbasirevic and colleagues report no relevant financial disclosures.
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