gms | German Medical Science

Objectives/Interrogation: Radial nerve is one of most war-related injuries due to drilling cutter tool injury or gunshot wounds, resulting Low-Hand Syndrome. We aimed to evaluate the outcomes of tendon transfer in the patients with Low-Hand Syndrome who injured in Syrian Civil War.

Methods: We evaluated the results of 13 patients who injured in Syrian Civil War between 2015 and 2017 years. Palmaris longus tendon was used for transferring to extensor pollicis longus for thumb extension. Pronator teres was transferred to extensor carpi radialis brevis for wrist extension. The flexor carpi radialis were transferred to the extensor digiti communis for the 2th, 3th, 4th and 5th finger extension. All outcomes of thumb abduction and extension, wrist extension, wrist flexion and fingers extension were assessed.

Results and Conclusions: There was a high level of radial nerve injury in all patients included in the study. Post-injury transfer period was 1.5 months at the earliest and 9 months at the latest. Among the injuries, the gunshot wound was the most reason observed in 8 cases (61.5%). Drill cutter injury (n:3; 23.1%) and humerus fracture (n:2; 15.4%) followed the gunshot wounds. As a result, radial nerve injury may achieve successful results with the tendon transfer. All patients regained their thumb abduction as much as around 60 degrees. They have the ability of wrist bending and gripping, as all can extend their fingers in the positions of wrist flexion, neutral wrist and wrist extension. Although the reason for radial injury varies, the common point was that postoperative outcomes and rehabilitation period moved successfully in patients who underwent early repairs than 90 days.