Tendon transfers in radial nerve palsy with fractures of the humerus: Case reports

Case 1: A 25 year old right handed male soldier who was referred to Kenyatta National Hospital (KNH) in February 2008, from Burundi, with non-union of the left humerus and wrist drop. He sustained a compound fracture of the humerus and wrist drop following a gunshot injury a year earlier. Open reduction, plating of the humeral fracture and bone grafting coupled with tendon transfers resulted in significant initial functional recovery of the limb at 4 , months post-operatively. Case 2: A 29 year old right handed paramilitary male sustained fractures of the right humerus and right radius and ulna in a lorry accident. A wrist drop and inability to actively extend the fingers and thumb was noted when he was admitted to KNH in March 2008. Internal fixation of fractures was done. The radial nerve was in continuity. There was no radial nerve recovery after 19 months. Tendon transfers were done resulting in significant initial functional recovery noted at 3 months post operatively. Tendon transfers to restore function is a good option where radial nerve recovery is not anticipated. This can also save careers. East African Orthopaedic Journal, Vol. 4: March 2010