Transfer of extensor carpi radialis brevis as an extensor to extensor motor transfer (EEMT) in ulnar nerve palsy.

OBJECTIVE: To evaluate functional outcome and correction of deformity with extensor carpiradialis brevis motor transfer to replace the intrinsic muscles as an extensor to extensor motor transfer (EEMT).

METHOD: This was a prospective observational study with one group pretest posttest design conducted from 1996 to 2004. Convenience sampling technique was used and the sample size was twenty one. The independent variable was transfer of extensor carpiradialis brevis to replace the intrinsic muscles. The dependent variable was functional outcome and the correction of deformity. The extraneous variables were age, sex interval between injury and transfer as well as local factors related to wound and grafts used. The average follow up was 22.5 months.

RESULTS: The mean preoperative unassisted extensor lag was 56.79 +/- 10.39 which improved to 9.6% +/- 5.4 (correction of 83%) at six months after surgery. With open hand assessment 76.19% reported good to excellent results, while 79.89% achieved good to excellent results with closed hand assessment. The mechanism of closing was good to excellent in 89.42% cases, however only 71.42% patients considered their hands good to excellent. Significant problems were seen with use of tendoachilles as a graft.

CONCLUSION: Extensor carpiradialis brevis transfer to replace the intrinsic muscles as an extensor to extensor motor transfer can achieve good functional outcome as well as correction of deformity despite shortcomings in physical rehabilitation.