Challenge of the Week / Hand & Wrist / 2.12.2020

A patient presents 2 years after an ulnar nerve laceration at the wrist that was never repaired. Which of the following treatments can improve the patient’s hand function?
    • Tendon transfer to improve thumb abduction
    • Opponensplasty procedures are tendon transfer procedures that can be performed to improve thumb abduction in median nerve palsies


    • Tendon transfer to correct pseudoclawing
    • Tendon transfers, such as the Zancolli lasso procedure, can be performed to correct late clawing from an ulnar nerve palsy


    • Wrist fusion
    • An ulnar nerve laceration at the wrist would result in loss of intrinsic hand function and clawing. Wrist flexion and extension would not be affected, and wrist fusion is not indicated


    • Tendon transfer to the extensor pollicis longusy
    • An extensor indicis proprius tendon transfer to the extensor pollicis longus is performed for an attritional rupture of the extensor pollicis longus, as can occur in the setting of a distal radius fracture


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