Rehabilitative Operation for Motor Neuron Disease: Tendon Transfer for Segmental Muscular Atrophy of the Upper Extremities  MEHRSHEED SINAKI, M.D.  Mayo.

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Rehabilitative Operation for Motor Neuron Disease: Tendon Transfer for Segmental Muscular Atrophy of the Upper Extremities  MEHRSHEED SINAKI, M.D.  Mayo Clinic Proceedings  Volume 59, Issue 5, Pages 338-342 (May 1984) DOI: 10.1016/S0025-6196(12)61430-X Copyright © 1984 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 1 Preoperative photographs. A, Patient attempting to grasp with her right hand. B, Patient demonstrating maximal wrist and finger extension of right upper extremity. Mayo Clinic Proceedings 1984 59, 338-342DOI: (10.1016/S0025-6196(12)61430-X) Copyright © 1984 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 2 A, Diagram of dorsoulnar aspect of right upper extremity. Note the following tendon transfers: split triceps around humerus to biceps, flexor carpi radialis (FCR) around radial border of forearm to extensor carpi radialis longus (ECRL), and flexor digitorum superficialis III (FDS III) and IV (FDS IV) through interosseous membrane to extensor pollicis longus (EPL) and extensor digitorum communis (EDC), respectively. B, Diagram of dorsal aspect of right hand and wrist. Note the following tendon transfers: extensor carpi ulnaris (ECU) to extensor carpi radialis brevis (ECRB), flexor carpi radialis (FCR) around radial border of forearm to extensor carpi radialis longus (ECRL), and flexor digitorum superficialis III (FDS III) and IV (FDS IV) through interosseous membrane to extensor pollicis longus (EPL) and extensor digitorum communis (EDC), respectively. Mayo Clinic Proceedings 1984 59, 338-342DOI: (10.1016/S0025-6196(12)61430-X) Copyright © 1984 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 3 Postoperative photographs. A, Double-exposure showing finger range of motion. B, Double-exposure showing wrist range of motion. C, Patient showing ability to write. Mayo Clinic Proceedings 1984 59, 338-342DOI: (10.1016/S0025-6196(12)61430-X) Copyright © 1984 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 4 Nuclear magnetic resonance scan of brain and cervical cord in sagittal section is normal and shows no evidence of syrinx, intra-axial lesion, or mass at foramen magnum. Mayo Clinic Proceedings 1984 59, 338-342DOI: (10.1016/S0025-6196(12)61430-X) Copyright © 1984 Mayo Foundation for Medical Education and Research Terms and Conditions