Challenges and advances in the treatment of radial palsy in Argentina during 2024
DOI:
https://doi.org/10.56294/ri20269Keywords:
Radial palsy, tendon transfer, rehabilitation, health system, inequalityAbstract
In 2024, the management of radial nerve injuries in Argentina was profoundly influenced by structural, economic and health factors. The health system faced difficulties arising from the post-pandemic period, a prolonged economic crisis and unequal access to specialized resources. The high incidence of upper limb injuries was related to the increase in road and work accidents, as well as urban violence. These injuries mainly affected young males from vulnerable sectors.
Diagnosis depended, in many cases, on clinical experience, given the limited availability of studies such as electromyography. This reality caused diagnostic delays that reduced the chances of functional recovery. In terms of treatment, tendon transfers continued to be the most widely used technique in public hospitals due to their simplicity and low cost, while nerve transfers began to be implemented in more complex centers.
Post-surgical rehabilitation showed marked inequalities between regions. The shortage of specialized physiotherapists, coupled with the lack of continuity in treatments, negatively affected the results. In addition, many patients faced barriers to accessing orthotics, rehabilitation or postoperative check-ups, resorting to NGOs or solidarity campaigns.
From the academic sphere, research into surgical treatments was promoted and 3D printing was explored as an alternative for personalized splints. Although significant progress was made, gaps in infrastructure and resources limited its impact.
References
1. Carls J, Rab M. Transferencia tendinosa para el tratamiento de la parálisis de extensión de la mano. Técnicas Quirúrgicas en Ortopedia y Traumatología. Disponible en: https://www.elsevier.es/es-revista-tecnicas-quirurgicas-ortopedia-traumatologia-----41-articulo-transferencia-tendinosa-tratamiento-paralisis-extension-mano-13054518.
2. Bumbasirevic M, Lesic A, Bumbasirevic V, Cobeljic G, Milosevic I, Atkinson HDE. Radial nerve palsy. EFORT Open Rev. 2017;1(8):286-294. Disponible en: https://eor.bioscientifica.com/view/journals/eor/1/8/2058-5241.1.000028.xml.
3. Belayneh R, Lott A, Haglin J, Konda S, Leucht P, Egol K. Resultados finales de la parálisis del nervio radial asociada a fractura y pseudoartrosis de la diáfisis humeral. J Orthop Traumatol. 2019;20:18. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6439110/.
4. Ray WZ, Mackinnon SE. Resultados clínicos tras transferencias del nervio mediano al radial. J Hand Surg Am. 2011;36(2):201-208. Disponible en: https://www.jhandsurg.org/article/S0363-5023(10)01190-1/abstract.
5. Vértiz AJ. Parálisis del nervio radial. Rev Asoc Argent Ortop Traumatol. 2007;72(2):127-136. Disponible en: https://www.aaot.org.ar/revista/2007/n2_vol72/art13.pdf.
6. Kenhub. Nervio radial. Disponible en: https://www.kenhub.com/es/library/anatomia-es/nervio-radial.
7. Compton J, Owens J, Day M, Caldwell L. Revisión sistemática de la transferencia tendinosa versus transferencia nerviosa para la restauración de la extensión de la muñeca en la parálisis traumática aislada del nervio radial. JAAOS Glob Res Rev. 2018;2(4):e001. Disponible en: https://journals.lww.com/jaaosglobal/fulltext/2018/04000/systematic_review_of_tendon_transfer_versus_nerve.5.aspx.
8. Bertelli JA, Ghizoni MF. Resultados del injerto nervioso en lesiones del nervio radial que ocurren proximal al húmero, incluyendo aquellas dentro del cordón posterior. J Neurosurg. 2016;124(1):179-185. Disponible en: https://pubmed.ncbi.nlm.nih.gov/26274998/.
9. Agarwal P, Kukrele R, Sharma D. Resultados de la transferencia tendinosa para la parálisis del nervio radial utilizando la combinación del flexor carpi radialis (transferencia de Brands). J Clin Orthop Trauma. 2020;11(4):630-636. Disponible en: https://www.journal-cot.com/article/S0976-5662(20)30180-6/pdf.
10. Belayneh R, Lott A, Haglin J, Konda S, Leucht P, Egol K. Final outcomes of radial nerve palsy associated with humeral shaft fracture and nonunion. J Orthop Traumatol. 2019;20:18. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6439110/.
11. Ray WZ, Mackinnon SE. Clinical outcomes following median to radial nerve transfers. J Hand Surg Am. 2011;36(2):201-208. Disponible en: https://pubmed.ncbi.nlm.nih.gov/21168979/.
12. Bertelli JA, Ghizoni MF. Results of nerve grafting in radial nerve injuries occurring proximal to the humerus, including those within the posterior cord. J Neurosurg. 2016;124(1):179-185. Disponible en: https://pubmed.ncbi.nlm.nih.gov/26274998/.
13. Agarwal P, Kukrele R, Sharma D. Outcome of tendon transfer for radial nerve palsy using Flexor Carpi Radialis combination (Brands transfer). J Clin Orthop Trauma. 2020;11(4):630-636. Disponible en: https://www.journal-cot.com/article/S0976-5662(20)30180-6/pdf.
14. Compton J, Owens J, Day M, Caldwell L. Systematic review of tendon transfer versus nerve transfer for the restoration of wrist extension in isolated traumatic radial nerve palsy. JAAOS Glob Res Rev. 2018;2(4):e001. Disponible en: https://journals.lww.com/jaaosglobal/fulltext/2018/04000/systematic_review_of_tendon_transfer_versus_nerve.5.aspx.
15. Belayneh R, Lott A, Haglin J, Konda S, Leucht P, Egol K. Final outcomes of radial nerve palsy associated with humeral shaft fracture and nonunion. J Orthop Traumatol. 2019;20:18. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6439110/.
16. Ray WZ, Mackinnon SE. Clinical outcomes following median to radial nerve transfers. J Hand Surg Am. 2011;36(2):201-208. Disponible en: https://pubmed.ncbi.nlm.nih.gov/21168979/.
17. Bertelli JA, Ghizoni MF. Results of nerve grafting in radial nerve injuries occurring proximal to the humerus, including those within the posterior cord. J Neurosurg. 2016;124(1):179-185. Disponible en: https://pubmed.ncbi.nlm.nih.gov/26274998/.
18. Agarwal P, Kukrele R, Sharma D. Outcome of tendon transfer for radial nerve palsy using Flexor Carpi Radialis combination (Brands transfer). J Clin Orthop Trauma. 202.
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