Orthopaedic Sports Medicine Center of Ioannina

Traumatic lesion of the deep branch of the radial nerve (posterior interosseous nerve) causes paralysis of the finger and thumb extension while wrist extension is maintained. There is no sensory disturbance. The lesion can be caused by knife injury, by Monteggia lesions and iatrogenically by procedures at the proximal radius. Traumatic disconnection of the posterior interosseous nerve is a good indication for early surgical exploration of the nerve; microsurgical reconstruction should then be carried out. When nerve repair has not been done or has been unsuccessful, finger and thumb extension can be achieved by various methods of tendon transfer. No transfer is necessary for the wrist. In two cases with fresh discission of the deep branch of the radial nerve (one after knife injury and one due to plate osteosynthesis of the radius) a microsurgical reconstruction was done. In two other cases with an old lesion after procedures on the proximal radius and unsuccessful nerve reconstruction a tendon transfer was done. In the two cases of acute microsurgical intervention the recovery was complete. In the two cases of tendon transfer good restoration of the finger and thumb extension was achieved.