title: Simultaneous powering of forearm pronation and key pinch in tetraplegia using a single muscle-tendon unit.
abstract: This study clinically assessed the concept that both thumb flexion and forearm pronation can be restored by brachioradialis (BR)-to-flexor pollicis longus (FPL) tendon transfer if the BR is passed dorsal to the radius. Six patients [two women and four men, mean age 32.3 years (SD 4.9, range 23-56)] underwent BR-to-FPL transfer dorsal to the radius and through the interosseous membrane (IOM). Lateral key pinch strength and pronation range of motion (ROM) were measured 1 year after surgery. A group of six patients [two women and four men, mean age 31.2 years (SD 5.0, range 19-52)] who underwent traditional palmar BR-to-FPL was included for comparison. Postoperative active pronation was significantly greater in the dorsal transfer group compared to the palmar group [149 (SD 6) and 75 (SD 3), respectively] and pinch strength was similar in the two groups [1.28 (SD 0.16) kg and 1.20 (SD0.21) kg, respectively]. We conclude that it is feasible to reconstruct lateral key pinch and forearm pronation simultaneously using only the BR motor.
authors: Department of Hand Surgery, Sahlgrenska University Hospital, Göteborg, Sweden. jan.friden@orthop.gu.se
authors: J
authors: J
authors: Fridén
authors: C
authors: C
authors: Reinholdt
authors: A
authors: A
authors: Gohritz
authors: W J
authors: WJ
authors: Peace
authors: S R
authors: SR
authors: Ward
authors: R L
authors: RL
authors: Lieber
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena / Q000502:physiology*; D005260:Female; D005542:Forearm / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000637:transplantation*; D052581:Pinch Strength; D011403:Pronation / Q000502:physiology*; D011782:Quadriplegia / Q000503:physiopathology / Q000601:surgery*; D016059:Range of Motion, Articular; D013709:Tendon Transfer / Q000379:methods*; D055815:Young Adult