Bhardwaj Praveen, Varadharajan Vigneswaran, Venkatramani Hari, Sabapathy S Raja
Department of Plastic, Hand & Reconstructive Microsurgery, Ganga Hospital, Coimbatore, Tamil Nadu, India.
J Hand Surg Asian Pac Vol. 2022 Aug;27(4):755-759. doi: 10.1142/S2424835522720353. Epub 2022 Aug 8.
The usual recommendation in posterior interosseous nerve (PIN) palsy is to use the flexor carpi radialis instead of the flexor carpi ulnaris (FCU) for restoration of digital extension. The use of FCU takes away the only remaining ulnar deviator of the wrist. Although preserving the FCU prevents severe radial deviation deformity, we found that some patients still develop a radial deviation deformity, especially during wrist extension. We have used a brachioradialis (BR) to extensor carpi ulnaris (ECU) transfer to prevent the development of a radial deviation deformity and find that it restores the normal radio-ulnar balance of the wrist by providing a dynamic ulnar stabiliser. It is a simple addition to the standard two tendon transfers for PIN palsy with minimal donor morbidity. We have used this triple transfer for PIN palsy in seven patients with satisfactory results and no complications. Level V (Therapeutic).
在正中神经后骨间神经（PIN）麻痹中，通常的建议是使用桡侧腕屈肌而不是尺侧腕屈肌（FCU）来恢复手指伸展。使用 FCU 会带走手腕唯一剩下的尺侧屈肌。尽管保留 FCU 可以防止严重的桡侧偏斜畸形，但我们发现一些患者仍会出现桡侧偏斜畸形，尤其是在手腕伸展时。我们已经使用肱桡肌（BR）向尺侧腕伸肌（ECU）转移来防止桡侧偏斜畸形的发展，并发现它通过提供动态尺侧稳定器来恢复手腕的正常桡尺侧平衡。这是对 PIN 麻痹的标准两肌腱转移的简单补充，供区并发症很少。我们已经在七例 PIN 麻痹患者中使用这种三肌腱转移，效果满意，无并发症。 5 级（治疗）。
