Double-Flexor Tendon Transfer for Radial Nerve Laceration Secondary to Holstein-Lewis Fracture: A Case Report

The purpose of this article is to present a case where a double flexor tendon transfer was used to restore thumb, finger and wrist extension in a patient who sustained a complete radial nerve transection secondary to a distal humeral shaft or Holstein-Lewis Fracture. The patient in this case sustained his injury during a motor vehicle collision. He subsequently underwent open reduction and internal fixation (ORIF) with exploration of his radial nerve, which was completely transected. The patient then underwent tendon transfer to restore his thumb, finger and wrist function. Tendon transfers using Flexor Carpi Ulnaris, Flexor Digitorum Superficialis, and Pronator Teres were utilized to restore function. Typically it is not ideal to utilize two flexor tendons, but because the patient lacked a Palmaris Longus it was necessary in this case. When performing such a procedure it is expected that wrist and digital flexion will be negatively impacted which was not seen in this case.