Affiliations: Department of Plastic, Reconstructive and Hand
Surgery, VU University Medical Center, Amsterdam, The Netherlands | Department of Rehabilitation Medicine, VU University
Medical Center, Amsterdam, The Netherlands | Research Institute MOVE, Faculty of Human Movement
Sciences, VU University, Amsterdam, The Netherlands | Department of Orthopaedic Surgery, VU University
Medical Center, Amsterdam, The Netherlands
Note: [] Corresponding author: N.A. van Alphen, Department of Plastic,
Reconstructive and Hand Surgery. De Boelelaan 1117, 1081 HV Amsterdam, The
Netherlands. Tel.: +31 6 27218414; Fax: +31 20 4440151; E-mail:
na.vanalphen@vumc.nl
Abstract: Wrist extension is essential in the development of motor skills in
young children. Adequate wrist extension is important for good grip function of
the hand, as a slightly extended wrist results in a better and stronger grip.
This retrospective study reviews the transfer of the flexor carpi ulnaris (FCU)
or flexor carpi radialis (FCR) to the extensor carpi radialis brevis (ECRB)
and/or longus (ERCL) to reconstruct wrist extension in 19 patients with
obstetric brachial plexus palsy (OBPP). The average age at surgery was 7.2
(range 4–18) years. The mean follow-up was 3 years. Preoperatively, none
of the patients had active wrist extension, with an average wrist extension-lag
of 37.4 (SD 15.1) degrees. Postoperatively, average active wrist extension was
9.2 (SD 25.5) degrees. Average gain in wrist extension was 46.6 (SD 28.2)
degrees, however individual gain varied substantially, i.e. between 0 and 100
degrees. Two patients were unable to reach the neutral wrist position
postoperatively and in two patients wrist extension did not increase. The
results of the tendon transfer to provide improvement of wrist extension in
OBPP were satisfactory in most patients.
