الفهرس 
Pathophysiology of Radial Nerve InjuryOnly 14 pages are availabe for public view
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Abstract
High radial nerve injury; proximal to the origin of the posterior interosseous nerve (PIN) , results in loss of active extension of the wrist, fingers and thumb due to paralysis of the extensor carpi-radialis longus (ECRL), the extensor carpi-radialis brevis (ECRB), and the extensor carpi ulnaris (ECU) for the wrist, the extensor digitorum (ED), extensor indicis (EI), and extensor Digiti minimi (EDM) for the fingers, and extensor pollicis longus (EPL) for the thumb, also loss of thumb abduction due to paralysis of abductor pollicis longus (APL) and extensor pollicis brevis (EPB), beside sensory loss over the anatomical snuffbox.
In high radial nerve injury, the greatest loss in hand function is weakness of grip due to inability to extend the wrist.
Different options were emerged to gain the hand functions while waiting for nerve recovery which extended beyond the year if the injury was so high. Some authors recommend early full tendon transfers without any trial for repair of the injured nerve, this could be accepted if there is no hope of nerve recovery, others recommend early transfer of pronator teres (PT) to extensor carpi radialis brevis (ECRB) and found that this method restores wrist extension quickly, leading to grip and pinch powers improvement. Also, there is no need for an external splint for a long time till the nerve regeneration occurs. Nerve recovery was reported in 63% to 77% patients who had nerve repair.
A tendon transfer is relocation of the insertion of a functioning MTU to restore lost function of another.
The important points should be highlighted during tendon transfer procedure are:
1. The transfer shouldn’t significantly decrease the remaining hand function. 2. The transfer shouldn’t cause a deformity if functional recovery occurs following a nerve repair.
Early full tendon transfer carries the risk of overfunction when the nerve regenerates, beside that carries donor site morbidity. It was reported that patients wearing the splint during the day were unsatisfied and feeling uncomfortable, and the splint was hindering them, also leaving the hand dropped will disturb the wrist biomechanics due to extensor tendons elongation.
In our thesis we chose to primarily repair the nerve beside transfer of PT to ECRB at the same time, this will support the hand function, rapid recovery and return to work early will occur and decrease the tension on the repaired nerve.