The Clinical Results of Tendon Transfers in Patients with Ulnar Palsy
Abstract
Objective: In this study, we aimed to evaluate the results of our preferred tendon transfer methods for deformities in 14 patients with high and low ulnar nerve palsy.
Methods: Between 2012 and 2018, 14 patients, 3 female and 11 male, with average follow-up of 5 (min: 2 max: 8) years, 6 low and 8 high level, average of 6.2 (min: 2 max: 20) years from injury to surgery were evaluated in the study. The last examinations and tests of the patients were performed in our clinic after their consent was obtained. The claw hand presence, Froment sign, Wartenberg sign, key pinch test, strong grip measurement, Quick Dash (QD) test, satisfaction questioning and complications were evaluated in the examinations of the patients.
Results: For claw hand; Zancolli lasso procedure was underwent using splits of FDS-3 in 11 patients, FDS-4 and FDS-5 in 2 patients. For the Wartenberg sign; the EDM tendon was passed through the extensor hood and A2 pulley tenodesis was performed in 13 patients. Tenodesis was performed in 12 patients using ECRB tendon for thumb adductorplasty. The EIP tendon was transferred to the 1st interosseous in 12 patients for 2nd finger abduction and improve key pinch. Tenodesis was underwent to 2nd-5th FDP’s at the wrist level for the patients with high ulnar palsy. Complications such as claw hand recurrance in one, flexion contracture of the 5th finger in 1, and hyperabduction of the index finger in 2 patients were found. The strong grip and key pinch measurements were evaluated as % 62.7(max: 85 min: 22) and %63.4(max: 90 min: 33) on average compared to the opposite hand. Postop QD mean scores of the patients were evaluated as 36.8 (max: 45 min: 9.5).
Conclusion: When dealing with the sequelae of late ulnar nerve palsy, each patient's needs should be carefully evaluated and choosing suggested transfer methods.