Key result
FCU or FCR tendon transfer linked to ~47-degree gain in active wrist extension.
Why the study?
Wrist extension is essential for motor skill development and good grip function in children with obstetric brachial plexus palsy, but restoration methods require evaluation.
Does tendon transfer of wrist flexors to wrist extensors improve wrist extension in patients with obstetric brachial plexus palsy?
Observational (n=19)
Does tendon transfer of wrist flexors to wrist extensors improve wrist extension in patients with obstetric brachial plexus palsy?
Tendon transfer of wrist flexors to extensors provides satisfactory improvement in wrist extension for most patients with obstetric brachial plexus palsy.
Answers are grounded in this paper and cite their sources.
May support tendon transfer for wrist extension in obstetric brachial plexus palsy; leaves open need for controlled trials to confirm benefit.
Wrist extension is essential in the development of motor skills in young children. Adequate wrist extension is important for good grip function of the hand, as a slightly extended wrist results in a better and stronger grip. This retrospective study reviews the transfer of the flexor carpi ulnaris (FCU) or flexor carpi radialis (FCR) to the extensor carpi radialis brevis (ECRB) and/or longus (ERCL) to reconstruct wrist extension in 19 patients with obstetric brachial plexus palsy (OBPP). The average age at surgery was 7.2 (range 4-18) years. The mean follow-up was 3 years. Preoperatively, none of the patients had active wrist extension, with an average wrist extension-lag of 37.4 (SD 15.1) degrees. Postoperatively, average active wrist extension was 9.2 (SD 25.5) degrees. Average gain in wrist extension was 46.6 (SD 28.2) degrees, however individual gain varied substantially, i.e. between 0 and 100 degrees. Two patients were unable to reach the neutral wrist position postoperatively and in two patients wrist extension did not increase. The results of the tendon transfer to provide improvement of wrist extension in OBPP were satisfactory in most patients.
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Alphen et al. (2013) conducted an observational in obstetric brachial plexus palsy (OBPP) (n=19). Transfer of the flexor carpi ulnaris (FCU) or flexor carpi radialis (FCR) to the extensor carpi radialis brevis (ECRB) and/or longus (ERCL) was evaluated on Active wrist extension (Mean gain 46.6 degrees). Tendon transfer of the FCU or FCR to the ECRB and/or ERCL in patients with obstetric brachial plexus palsy improved active wrist extension by an average of 46.6 degrees.
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