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Functional grasp begins with opening the hand to reach around an object. The ability to open the hand is controlled by the extrinsic extensor and intrinsic muscles of the hand. The extrinsic extensor muscles, along with the extensor carpi ulnaris (ECU), are innervated by the posterior interosseous nerve (PIN). The supinator to PIN nerve transfer is often performed to reanimate digital extension in the setting of spinal cord or lower plexus injury. This surgery also aims to rebalance and centralize wrist extension (ECU). Phase 1 of rehabilitation emphasizes donor activation with active supination and progresses to combined activation of supination with passive extension of the fingers and thumb. Phase 2 is characterized by active-assisted and active digital extension while demanding a strong contraction of the supinator. Resistive exercise is not initiated until phase 3, when the PIN muscles have reached 3+/5 muscle strength.

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Supinator Branch of the Radial Nerve to the Posterior Interosseous Nerve Transfer

  • 章节

  • 发表日期：

    2025年

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  • Jennifer Q. Farrar,
  • Lorna C. Kahn

摘要

Functional grasp begins with opening the hand to reach around an object. The ability to open the hand is controlled by the extrinsic extensor and intrinsic muscles of the hand. The extrinsic extensor muscles, along with the extensor carpi ulnaris (ECU), are innervated by the posterior interosseous nerve (PIN). The supinator to PIN nerve transfer is often performed to reanimate digital extension in the setting of spinal cord or lower plexus injury. This surgery also aims to rebalance and centralize wrist extension (ECU). Phase 1 of rehabilitation emphasizes donor activation with active supination and progresses to combined activation of supination with passive extension of the fingers and thumb. Phase 2 is characterized by active-assisted and active digital extension while demanding a strong contraction of the supinator. Resistive exercise is not initiated until phase 3, when the PIN muscles have reached 3+/5 muscle strength.