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Vol. 21, Art. 89 (pp. 1157-1164)    |    2020       

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Possibilities of tendon-muscle transposition in severe tractive radial nerve damage. (clinical observation)

Federal state budgetary institution "413 military hospital" of the
Ministry of Defense Russian Federation

Brief summary

The article presents a clinical observation of a patient with a characteristic deformity of the "drooping hand" type and sensory disorders on the back of the hand, which developed after falling from a ladder onto an outstretched arm. Electroneuromyography (ENMG) and ultrasound examination (US) of the radial nerve, performed 2 days after injury, revealed severe traction nerve injury of the mixed type. During the follow-up examination a month later and according to the results of the repeated ENMG, there was no positive clinical and electrophysiological dynamics: the rate of excitation conduction remained extremely low, the number of motor units decreased. The patient underwent revision, neurolysis of the radial nerve, type 6 nerve damage was verified according to the Sunderland's classification, improved by Mackinnon and Dellon with incomplete violation of the integrity of the epineural membrane. Due to the low probability of restoration of hand function, the patient underwent one-stage tendon-muscle transposition. In the postoperative period, within 3 months, against the background of rehabilitation measures, the patient recovered dorsiflexion of the hand, extension of the main phalanges of 2-5 fingers, extension and abduction of 1 finger. In severe traction injuries of the radial nerve and the absence of clinical and electrophysiological recovery for 1-2 months, the use of tendon-muscle transposition is an effective method of orthopedic correction, which helps to restore hand function and return patients to working capacity.


Key words

radial nerve palsy, electroneuromyography, tendon-muscle transposition, traction damage.

Reference list

1. Gaidar B. V. Prakticheskaya neirohiryrgiya. Pod redakciei chl.-korr. RAMN, prof. Gaidara V. B. - 2002, str.245


2. Kosov I. S., Golybev V. G. M. Khir Bek. Elektrofiziologicheskie oshibki pri diagnostike travmaticheskoi neiropatii lychevogo nerva: tez //Sovremennie tehnologii diagnostiki, lecheniya i reabilitacii pri povrejdeniyah i zabolevaniyah verhnei konechnosti. - 2007. - S. 44.


3. Vasilev M. V. Hiryrgicheskoe lechenie bolnih s izolirovannim povrejdeniem lychevogo nerva i v sochetanii s perelomom plechevoi kosti: dis. - GOYDPO "Kazanskaya gosydarstvennaya medicinskaya akademiya", 2010.


4. Hannanova I. G. i dr. Primenenie elektroneiromiografii dlya vibora taktiki operativnogo lecheniya povrejdenii lychevogo nerva //Prakticheskaya medicina. - 2011. - 55.


5. Sammer D. M., Chung K. C. Tendon transfers part I: principles of transfer and transfers for radial nerve palsy //Plastic and reconstructive surgery. - 2009. - T. 123. - 5. - S.169.