KẾT QUẢ PHẪU THUẬT CHUYỂN GÂN THEO PHƯƠNG PHÁP SMITH ĐIỀU TRỊ LIỆT THẦN KINH QUAY CAO

Abstract

Background: High radial nerve palsy not only causes loss of wrist and finger extension, but also significantly reduces hand grip strength, seriously affecting hand function. Objective: Evaluate the result of Smith tendon transfer in high radial nerve palsy at 108 Military Central Hospital. Methods: A descriptive study of 43 patients with high radial nerve palsy from 03/2019 to 03/2024. The average follow-up was 37,6 ± 17,9 months. Functional evaluation base on Tajima criteria. Results: Males constituted the majority (31/43 cases, 72,1%). The mean extension range of the wrist was 45,84⁰ ± 11,51⁰ during finger extension and 30,81⁰ ± 11,81⁰ during finger flexion. The mean flexion range of the wrist was 32,60⁰ ± 9,95⁰ during finger extension and 47,85⁰ ± 10,83⁰ during finger flexion. 97,7% of patients achieved full finger extension when the wrist joint was extended beyond 10°. The mean angulation range of the index finger was 55,12⁰ ± 3,91⁰. The achieved grip strength was 68,0% compared to the unaffected side. The surgery did not induce radial deviation deformities of the wrist joint. 41/43 patients were satisfied with the surgical outcomes. 42/43 patients returned to their previous professions. 97,7% of patients achieved very good and good results, while 2,3% achieved fair results. Conclusions: Treating high radial nerve palsy using the Smith tendon transfer method yields very good results. The utilization of the pronator teres for wrist extensor transfer and the flexor carpi radialis for finger extensor transfer is appropriate and contributes to limiting wrist joint radial deviation deformities. This modified technique has been researched and recommended by various authors worldwide.