Chapter

Reconstruction after nerve injury

T.E.J. Hems

in Oxford Textbook of Trauma and Orthopaedics

Second edition

Published on behalf of Oxford University Press

Published in print August 2011 | ISBN: 9780199550647
Published online April 2011 | e-ISBN: 9780199608249 | DOI: http://dx.doi.org/10.1093/med/9780199550647.003.006009

Series: Oxford Textbooks

Reconstruction after nerve injury

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Late reconstructive procedures may improve function if there is persisting paralysis after nerve injury

Transfer of a functioning musculotendinous unit to the tendon of the paralysed muscle is the most common type of procedure

Passive mobility must be maintained in affected joints before tendon transfer can be performed

The transferred muscle should be expendable, have normal power, and have properties appropriate to the function it is required to restore

Tendon transfers can provide reliable improvement in function after isolated radial nerve palsy

A number of procedures have been described for reconstruction of thumb opposition but impaired sensation after median nerve injury may limit gain in function

Tendon transfers are possible to improve clawing of fingers and lateral pinch of the thumb after ulnar nerve palsy or other cases of intrinsic paralysis.

Chapter.  4085 words.  Illustrated.

Subjects: Trauma and Orthopaedic Surgery

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