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Review Question - QID 7700

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QID 7700 (Type "7700" in App Search)
A 29-year-old man sustained an open humeral fracture and underwent surgical fixation 1 year ago. At that time, the radial nerve was transected and repaired primarily. He now has persistent wrist drop and is unable to extend his digits. Nerve conduction velocity studies show no evidence of re-innervation. While discussing surgical options, the patient states that one of his hobbies is playing football. The most appropriate surgical reconstruction should include pronator teres transfer to the extensor carpi radialis brevis

alone.

3%

13/438

and the flexor carpi radialis to the extensor digitorum communis.

4%

18/438

and the flexor carpi ulnaris to the extensor digitorum communis.

9%

40/438

and the flexor carpi radialis to the extensor digitorum communis, and the palmaris longus to the extensor pollicis longus.

56%

246/438

and the flexor carpi ulnaris to the extensor digitorum communis, and the palmaris longus to the extensor pollicis longus.

26%

116/438

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The standard transfers for radial nerve palsy involve the pronator teres to the extensor carpi radialis brevis for central line of pull wrist extension. To power the extensor digitorum communis, the choice is between the flexor carpi radialis and the flexor carpi ulnaris. In a patient who needs power in throwing and needs to generate ulnarly directed flexion, it is important to preserve the flexor carpi ulnaris function; therefore, the flexor carpi radialis is the better choice. Furthermore, the thumb extension deficit should be corrected and the palmaris longus makes a good choice.

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