Brachioradialis tendon transfer and palmaris longus tendon graft for thumb avulsion:A case report and review of literature  

作　　者：Pierre Curings Sonia Ramos-Pascual Kinga Michalewska Nicolas Gibert Lionel Erhard Mo Saffarini AlexisNogier 

机构地区：[1]Department of Hand Surgery,Clinique Trenel,Sainte-Colombe 69560,France [2]Medical Research,ReSurg SA,Nyon 1260,Vaud,Switzerland [3]Department of Hand Surgery,Hand and Upper Limb Surgical Institute,Villeurbanne 69100,France [4]Department of Orthopaedics,Clinique Trenel,Sainte-Colombe 69560,France

出　　处：《World Journal of Clinical Cases》2025年第4期48-55,共8页世界临床病例杂志（英文）

摘　　要：BACKGROUND Thumb replantation following complete traumatic avulsion requires complex techniques to restore function,especially in cases of avulsion at the level of the metacarpophalangeal joint(MCP I)and avulsion of the flexor pollicis longus(FPL)at the musculotendinous junction.Possible treatments include direct tendon suture or tendon transfer,most commonly from the ring finger.To optimize function and avoid donor finger complications,we performed thumb replantation with flexion restoration using brachioradialis(BR)tendon transfer with palmaris longus(PL)tendon graft.CASE SUMMARY A 20-year-old left-handed male was admitted for a complete traumatic left thumb amputation following an accident while sliding from the top of a handrail.The patient presented with skin and bone avulsion at the MCP I,avulsion of the FPL tendon at the musculotendinous junction(zone 5),avulsion of the extensor pollicis longus tendon(zone T3),and avulsion of the thumb’s collateral arteries and nerves.The patient was treated with two stage thumb repair.The first intervention consisted of thumb replantation with MCP I arthrodesis,resection of avulsed FPL tendon and implantation of a silicone tendon prosthesis.The second intervention consisted of PL tendon graft and BR tendon transfer.Follow-up at 10 months showed good outcomes with active interphalangeal flexion of 70°,grip strength of 45 kg,key pinch strength of 15 kg and two-point discrimination threshold of 4 mm.CONCLUSION Flexion restoration after complete thumb amputation with FPL avulsion at the musculotendinous junction can be achieved using BR tendon transfer with PL tendon graft.

关 键 词：Brachioradialis tendon transfer Flexor pollicis longus Palmaris longus tendon graft REPLANTATION Thumb amputation Thumb avulsion Case report 

分 类 号：R68[医药卫生—骨科学]