Some patients with cerebral palsy can be helped by surgical reconstruction of the hand and forearm. These patients require careful evaluation and a trial of conservative therapy before undertaking the reconstructive procedure. In selected cases appropriate tendon transfers can be extremely beneficial to the patient.
The brachioradialis has been found to be strong and under voluntary control in a high proportion of patients with spastic paralysis. Thorough mobilization of the muscle gives it sufficient amplitude for use as a transfer. The use of the brachioradialis as a motor has been described in thirty-three tendon transfers in patients with cerebral palsy. Twenty-eight hands were improved and five showed no improvement in hand and forearm function.