STRATEGY and INDICATIONS

STRATEGY and INDICATIONS

Group 7


SITUATION (see table)	Remaining functions	active flexion and extension of the elbow active pronation and supination of the forearm active and strong extension and flexion of the wrist active extension of fingers MP joints active abduction and retropulsion of the thumb
	Paralysed functions	active flexion of the fingers intrinsic functions of the fingers all intrinsic functions of the thumb active flexion of the thumb
	Muscles available for transfers	BR ECRL (ECRI) PT ECU EDM EIP




SUGGESTED SURGICAL PROGRAM	Only one surgical stage	intrinsic palliative of the fingers (4 indirect lassos powered by ECU) restoration of fingers flexion (ECRL to FDP transfer) restoration of pinch closure (BR-to-FPL transfer) restoration of antepulsion and adduction of the thumb (EIP transfer according to Chouhy Kaplan)	Postoperative immobilization : 4 weeks (elbow in flexion at 90°, wrist in flexion, fingers MP joints in flexion, thumb in antepulsion and abduction)