title: Clinical outcomes following median to radial nerve transfers.
abstract: OBJECTIVE
  To evaluate the clinical outcomes in patients with radial nerve palsy who underwent nerve transfers using redundant fascicles of median nerve (innervating the flexor digitorum superficialis and flexor carpi radialis muscles) to the posterior interosseous nerve and the nerve to the extensor carpi radialis brevis.
  
  
  METHODS
  This was a retrospective review of the clinical records of 19 patients with radial nerve injuries who underwent nerve transfer procedures using the median nerve as a donor nerve. All patients were evaluated using the Medical Research Council (MRC) grading system. The mean age of patients was 41 years (range, 17-78 y). All patients received at least 12 months of follow-up (range, 20.3 ± 5.8 mo). Surgery was performed at a mean of 5.7 ± 1.9 months postinjury.
  
  
  RESULTS
  Postoperative functional evaluation was graded according to the following scale: grades MRC 0/5 to MRC 2/5 were considered poor outcomes, whereas an MRC grade of 3/5 was a fair result, 4/5 was a good result, and 4+/5 was an excellent outcome. Postoperatively, all patients except one had good to excellent recovery of wrist extension. A total of 12 patients recovered good to excellent finger and thumb extension, 2 had fair recovery, and 5 had poor recovery.
  
  
  CONCLUSIONS
  The radial nerve is commonly injured, causing severe morbidity in affected patients. The median nerve provides a reliable source of donor nerve fascicles for radial nerve reinnervation. The important nuances of both surgical technique and motor reeducation critical for the success of this transfer have been identified and are discussed.
  
  
  METHODS
  Therapeutic IV.
authors.affiliation: Department of Neurological Surgery and Division of Plastic and Reconstructive Surgery, Washington University, St Louis, MO 63110, USA.
authors.forename: Wilson Z
authors.initials: WZ
authors.lastname: Ray
authors.forename: Susan E
authors.initials: SE
authors.lastname: Mackinnon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000601:surgery*; D020423:Median Neuropathy / Q000175:diagnosis / Q000601:surgery*; D008875:Middle Aged; D016067:Nerve Transfer / Q000379:methods*; D011182:Postoperative Care / Q000379:methods; D011826:Radial Nerve / Q000601:surgery*; D020425:Radial Neuropathy / Q000175:diagnosis / Q000601:surgery*; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult