Restoration of Finger flexion and Prehension following Brachial Plexus Injury

May 29th, 2007

Brachial plexus injury to the C-8, T-1 nerve roots and lower trunk can have devastating impact on hand function. Finger flexion, fine coordination, and motion of the thumd are potentially lost.

Though few options exist to restore functional use, the wrist ECRL extensor tendon can be transferred to the finger flexors to restore some bend. Little exists to restore control to the mobile joint at the base of the thumb, but if this joint is fused to provide stability, the radial nerve-innervated Brachioradialis tendon can be transferred to the extrinsic thumb FPL tendon to restore flexion at the interphalangeal joint.

These interventions may restore modest, but useful function as shown in the videos below.

Related Photos:

The thumb CMC joint has been fused in a functional position of palmar abduction and pronation

Related Videos:

Preoperative video before ECRL to FDP and Brachioradialis to FPL transfers and Thumb CMC fusion

Outcome 7 months following surgery