Tendon Transfers for Radial and Median Nerve Palsies

Paralysis or irreparable injury to the radial or median nerve results in considerable impairment of hand function that directly affects activities of daily living. Radial nerve loss prevents wrist and digit extension, which hinders object acquisition and release. Median nerve loss deprives the hand of thumb function, especially opposition, which impedes prehension. Tendon transfers to restore function are indicated when nerve recovery is no longer expected. Tendon transfer can re-establish active movement and enhance function. The maximum benefit after tendon transfer, however, requires a close working relationship among patient, therapist, and physician. This article will highlight the surgical principles and rehabilitative process to achieve this goal.