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CC BY-NC-ND 4.0 · Indian J Plast Surg 2018; 51(02): 123-130
DOI: 10.4103/ijps.IJPS_7_18
Original Article
Association of Plastic Surgeons of India

Brachioradialis to flexor digitorum profundus tendon transfer to restore finger flexion

R. Srikanth
Department of Plastic and Reconstructive Surgery, Nizams Institute of Medical Sciences, Hyderabad, Telangana, India
,
Koteswara Rao Rayidi
Department of Plastic and Reconstructive Surgery, Nizams Institute of Medical Sciences, Hyderabad, Telangana, India
,
Subha Kakumanu
Department of Plastic and Reconstructive Surgery, Nizams Institute of Medical Sciences, Hyderabad, Telangana, India
› Author Affiliations
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Publication History

Publication Date:
26 July 2019 (online)

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ABSTRACT

Introduction: The main deformity following an adult lower brachial plexus injury is the loss of finger flexion. Distal nerve transfers have been used to restore finger and thumb flexion followed by tendon transfers for intrinsic replacement for opening of the fingers. When patients present beyond 6 months, only tendon transfers are applicable. Since the brachioradialis (BR) is always spared in such injuries, it is the ideal muscle to provide finger flexion. Wrist extensor power may not be normal for the use of the radial wrist extensor to serve as donor. BR to FDP transfer provides reasonable flexion range and an acceptable hand function to permit activities of daily living, when associated with ancillary procedures like opponensplasty, PIPJ arthrodesis. Materials and Methods: Eleven patients underwent a BR to FDP tendon transfer between January 2013 and January 2017 of which eight patients came for follow-up. Results: Four of the eight patients got a functionally useful hand to carry out activities of daily living with hook grip, span grasp, key pinch, chuck grip and pulp pinch. These patients also underwent simultaneous or secondary ancillary procedures. Four of the patients need secondary procedures to further improve functionality of the hand inspite of having a flexion range. Conclusion: The BR is an effective donor in providing adequate range and power of finger flexion in lower plexus injuries.

KEY WORDS

Brachial plexus injury - brachioradialis - finger flexion - flexor digitorum profundus - tendon transfer
 

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