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
