Evaluation of Different Modalities of Tendon Transfer in Ulnar Nerve Palsy

Background: Tendon transfer surgery is a type of hand surgery that is performed in order to improve lost hand function. A functioning tendon is shifted from its original attachment to a new one to restore the action that has been lost. Aim of the study: the present study was performed to evaluate the different modalities of tendon transfer in management of clawing of little and ring fingers in ulnar nerve palsy. Patients and Methods: Correction of clawing of ring and little fingers was done in 20 patients (with ulnar palsy whether high or low; age range: 5-60 years). Different techniques of tendon transfer were used including Zancolli-lasso procedure using flexor digitorum superficialis (FDS), Stiles Bunnel procedure using FDS and Brand procedure Results: Anti-claw procedures were performed in 20 cases, 10 patients showed excellent results, 6 patients showed good results, 3 patients showed fair results, while 1 patient showed poor result according to MRC grading system. Conclusion: It could be concluded that among many techniques of tendon transfer procedures prescribed for treatment of claw hand in ulnar nerve palsy, FDS transfer is the best reconstructive tendon transfer procedure for correction of ulnar claw hand especially in low ulnar palsy. In case of high ulnar palsy when FDS isn’t available ECRL transfer is the next choice.