Abstract
The term “plexic hand” refers to hand and wrist involvement in traumatic brachial plexus injuries and to remaining deficits after nerve surgery has been performed. From January 2000 to March 2008, reconstructive surgery (dynamic tenodesis) was performed on seven patients with C5, 6, 7, and 8 nerve root lesions of the brachial plexus to restore wrist and finger extension. This procedure has been used in seven patients (one female). Two patients with a lesion of the brachial plexus sustained a fracture of the affected limb. Preliminary nerve repair operations were required in four cases. One hundred percent (seven) of the patients had improved function following dynamic tenodesis. The extension angle of the wrist joint on grip was 19° on average. The flexion angle of the wrist joint needed to produce MP joint extension was 24.3° on average. A new dynamic extensor tenodesis technique is proposed. The extensor digitorum communis tendons are looped through dorsal carpal retinaculum ligament and sutured to themselves. Our results demonstrate that the extensor dynamic tenodesis procedure is an effective and simple means of restoring grip function for patients with C5, 6, 7, and 8 nerve root lesions.
Similar content being viewed by others
References
Binder JP, Revol M, Cormerais A, Laffont I, Pedelucq JP, Dizien O, Servant JM. Extensor tenodesis to the retinaculum extensorum: anatomic and biomechanical study. Chir Main. 2002
Jones R. On suture of nerves and alternative methods of treatment by transplantation of tendon. Br Med J. 1916;1:641–643.
Merle d’Aubigne R, Deburge A. Traitement des Paralysies du Plexus Brachial. Rev Chir Orthop. 1967;53:199–215.
Nagano A, Ochiai N, Okinaga S, Tachibana S, Mikami Y. Clinical features and treatment of brachial plexus injury involving C5, C6, C7, C8 roots. J Jpn Soc Surg Hand. 1989;6:422–425.
Ochiai N, Nagano A, Yamamoto S, Nakagawa T, Shibata K. Reconstruction of wrist and finger extension with tenodesis of extensor digitorum communis in brachial plexus injury. J Jpn Soc Surg Hand. 1994;10:806–809.
Ochiai N, Nagano A, Yamamoto S, Nakagawa T, Shibata K. Tenodesis of extensor digitorum in treatment of brachial plexus injuries involving C5, 6, 7 and 8 nerve roots. J Hand Surg (Br). 1995;20(5):671–674.
Ochiai N, Tsuyama N, Nagano A, et al. The root distribution in the motor innervation of the upper extremity: an analysis of 33 brachial plexus injuries. J Jpn Soc Surg Hand. 1984;1:535–539.
Omer G Jr. Tendon transfers for traumatic nerves injuries. J Hand Surg (A). 2004;4(3):214–226.
Scuderi G. Tendon transplants for irreparable radial nerve paralysis. Surg Gynecol Obstet. 1949;88:643–651.
Tubiana R. Notre Expérience des Transferts Tendineux Pour Paralysie Radiale. Ann Chir Main. 1985;4(3):197–210.
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Monreal, R. Dynamic Tenodesis of the Finger Extensors to Improve Hand Function After Brachial Plexus Injury. HAND 5, 256–260 (2010). https://doi.org/10.1007/s11552-009-9247-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11552-009-9247-y