Systematic Review of Tendon Transfer Versus Nerve Transfer for the Restoration of Wrist Extension in Isolated Traumatic Radial Nerve Palsy

PURPOSE: To compare the outcomes of tendon transfer and nerve transfer for radial nerve palsy. METHODS: We performed a systematic review of the literature in EMBASE, PubMed, and Cochrane Database to include studies that address persistent traumatic radial nerve palsy treated with tendon transfer or nerve transfer surgery. RESULTS: We identified 2,044 citations; 1,512 texts were excluded because of content, and 96 texts were screened for eligibility. Texts were excluded if they did not report the motor score (M0 to M5 as determined by the British Medical Research Council) or measurements of range of motion of the wrist. Sixteen texts were eligible for qualitative synthesis. Outcomes of these studies show heterogeneity with regard to the technique and functional restoration. CONCLUSIONS: On the basis of the results of this systematic review, there does not seem to be a clearly superior technique; rather, there are advantages and disadvantages to each. Patient selection and surgeon experience are important when considering surgical interventions in this challenging clinical scenario. Nerve transfer surgery is an emerging technique that may offer patients meaningful functional gains with reduced donor site morbidity. LEVEL OF EVIDENCE: Level III