Brachioradialis tendon transfer for a thumb and finger extension disorder owing to distal-type cervical spondylotic amyotrophy - a case report

Sep 30, 2026

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Finger extension reconstruction in distal-type cervical spondylotic amyotrophy often uses wrist flexor tendons as donors, yet C8 myotome involvement may impair wrist flexor function. Because the brachioradialis is mainly innervated by C6, it can be a favorable donor, though few reports describe its use. This case report describes a 72-year-old man with persistent thumb and finger extension deficits after cervical decompression. A brachioradialis tendon transfer to extensor pollicis longus and extensor digitorum communis improved extension lag and improved DASH from 30 to 11.6.

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CategoryHealthcare

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Case RepoRts in plastiC suRgeRy and Hand suRgeRy 2026, Vol. 13, no. 1, 2610522 [https://doi.org/10.1080/23320885.2025.2610522](https://doi.org/10.1080/23320885.2025.2610522) CASE REPORT Brachioradialis tendon transfer for a thumb and finger extension disorder owing to distal-type cervical spondylotic amyotrophy: a case report Risa Takenakaa, Takashi Odaa, Tsutomu Oshigirib, Takuro Wadaa and Atsushi Teramotobadepartment of orthopedic surgery, saiseikai otaru Hospital, otaru, Japan; bdepartment of orthopedic surgery, school of Medicine, sapporo Medical university, sapporo, Japan ABSTRACT To reconstruct finger extension in distal-type cervical spondylotic amyotrophy, wrist flexor tendons are commonly selected as the donor tendons. However, distal-type cervical spondylotic amyotrophy predominantly affects the C8 myotome, and therefore the wrist flexor muscles may also be impaired. The brachioradialis is mainly innervated by the C6 and is therefore less likely to be affected, it represents a favorable option asa donor tendon. However, there are few reports describing the use of the brachioradialis as a donor tendon. A 72-year-old man presented with limited active extension of his left ring and small fingers and thumb. Posterior cervical decompression was performed for cervical spondylotic amyotrophy (C8 segment involvement); however, at 12 months postoperatively, thumb and finger extension remained impaired. Instead of a wrist flexor transfer, we performed a brachioradialis tendon transfer to the extensor pollicis longus and extensor digitorum communis tendons. At 2 - year postoperative final follow-up, the extension lags of the 4th and 5th metacarpophalangeal joints and thumb had improved. His Disabilities of the Arm, Shoulder, and Hand score improved from 30 to 11.6 postoperatively. In finger and thumb extensor paralysis owing to distal cervical spondylotic amyotrophy, the brachioradialis muscle is typically spared and can be considered a donor for tendon transfer. This procedure, combined with extensive release of the fascial attachments, effectively improved dysfunction of finger and thumb extension without resulting in significant functional loss. ARTICLE HISTORY Received 21 July 2025 Accepted 23 December 2025 KEYWORDS Brachioradialis; cervical spondylotic amyotrophy; drop finger; finger extention disorder; tendon transfer Introduction Cervical spondylotic amyotrophy (CSA) is a disorder caused by cervical spondylotic changes, leading to impairment of the anterior horn or ventral root and resulting in upper limb-dominant muscle weakness and atrophy [1] . Distal-type CSA often presents with finger drops, and residual paralysis contributes to hand impairment. As sensory function remains intact, tendon transfer for finger extension can improve a patient’s activities of daily living (ADL) [2] . To reconstruct finger and thumb extension in distal-type CSA, the flexor carpi radialis (FCR) or flexor carpi ulnaris (FCU) or palmaris longus (PL) tendon is commonly selected as the donor tendon, according to the surgical procedure of reconstruction for radial nerve palsy. However, distal-type CSA predominantly affects the C8 myotome, and therefore wrist flexors may also be impaired. The brachioradialis (BR) is mainly innervated by the C6 and is therefore less likely to be affected, it represents a favorable option as a donor tendon. However, there are few reports describing the use of the BR as a donor tendon. Here, we report a case of BR tendon transfer to reconstruct a finger extension disorder owing to distal-type CSA following cervical decompression surgery and its management. CONTACT takashi oda [oda@sapmed.ac.jp](oda@sapmed.ac.jp) department of orthopedic surgery, saiseikai otaru Hospital, 10–1, Chikko, otaru 047-0008, Japan. © 2025 the author(s) . published by informa uK limited, trading as taylor & Francis group. this is an open access article distributed under the terms of the Creative Commons

FAQs

Why is brachioradialis considered a suitable donor tendon in distal-type cervical spondylotic amyotrophy?

Distal-type disease primarily affects the C8 myotome, which can also impair wrist flexors. The brachioradialis is mainly innervated by C6, making it less likely to be affected and a favorable donor option.

What surgical approach was used in this case?

After persistent extension impairment, a brachioradialis tendon transfer was performed to the extensor pollicis longus and extensor digitorum communis tendons, rather than transferring a wrist flexor tendon.

How did the patient’s function and disability score change after surgery?

At a 2-year final follow-up, extension lags of the 4th and 5th metacarpophalangeal joints and the thumb improved. The DASH score improved from 30 to 11.6 postoperatively.

Sep 30, 2026

Uploaded by Grenda