Flexor digitorum superficialis nerve transfer to restore pronation: two case reports and anatomic study.
Loss of pronation affects most activities of daily living. We report 2 cases of traumatic loss of pronator teres function and successful reconstruction by transfer of a redundant motor branch to the flexor digitorum superficialis to the pronator teres branch(es). Follow-up period was 2 years and pronation strength was restored to +4/5 and 5/5 in the 2 patients. The anatomy of the median nerve in the proximal forearm was examined by dissecting 31 cadaver specimens. A branching scheme was formulated. The histomorphometric properties of the individual muscular branches were studied in 15 fresh specimens to evaluate their suitability and size match for nerve transfer.
Tung
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Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St Louis, MO 63110, USA.
Mackinnon
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D000063:Accidents, Traffic; D000328:Adult; D002102:Cadaver; D006225:Hand / Q000033:anatomy & histology; D006230:Hand Injuries / Q000209:etiology / Q000601:surgery; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000033:anatomy & histology / Q000293:injuries* / Q000601:surgery*; D009407:Nerve Block / Q000009:adverse effects; D009408:Nerve Compression Syndromes / Q000209:etiology* / Q000601:surgery*; D016067:Nerve Transfer / Q000379:methods*; D011403:Pronation; D016059:Range of Motion, Articular