Brachioradialis tendon transfer and palmaris longus tendon graft for thumb avulsion: A case report and review of literature
Bibliographic record
Abstract
BACKGROUND: Thumb replantation following complete traumatic avulsion requires complex techniques to restore function, especially in cases of avulsion at the level of the metacarpophalangeal joint (MCP I) and avulsion of the flexor pollicis longus (FPL) at the musculotendinous junction. Possible treatments include direct tendon suture or tendon transfer, most commonly from the ring finger. To optimize function and avoid donor finger complications, we performed thumb replantation with flexion restoration using brachioradialis (BR) tendon transfer with palmaris longus (PL) tendon graft. CASE SUMMARY: A 20-year-old left-handed male was admitted for a complete traumatic left thumb amputation following an accident while sliding from the top of a handrail. The patient presented with skin and bone avulsion at the MCP I, avulsion of the FPL tendon at the musculotendinous junction (zone 5), avulsion of the extensor pollicis longus tendon (zone T3), and avulsion of the thumb's collateral arteries and nerves. The patient was treated with two stage thumb repair. The first intervention consisted of thumb replantation with MCP I arthrodesis, resection of avulsed FPL tendon and implantation of a silicone tendon prosthesis. The second intervention consisted of PL tendon graft and BR tendon transfer. Follow-up at 10 months showed good outcomes with active interphalangeal flexion of 70°, grip strength of 45 kg, key pinch strength of 15 kg and two-point discrimination threshold of 4 mm. CONCLUSION: Flexion restoration after complete thumb amputation with FPL avulsion at the musculotendinous junction can be achieved using BR tendon transfer with PL tendon graft.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".