Functional outcome of modified Jones procedure in patient with non-union Humerus and high radial nerve palsy: A case report

Middle to distal humeral fractures can cause high radial nerve palsy. A tendon transfer surgery can be performed to treat irreversible and longstanding radial nerve palsy in order to improve the lost hand function. A 39-year-old right-handed female office worker presented with deformity in her left arm and drop hand. She had a motorcycle accident a year before and was treated by a traditional bonesetter. The extension movements in her left wrist and fingers were restricted. We performed an ORIF with bone graft at her left nonunion humerus and also tendon transfer procedure to treat the high radial nerve palsy. We use the modified Jones procedure to attach the palmaris longus to the extensor pollicis longus. After that, we attached the flexor carpi radialis to extensor digitorum communis and extensor carpi radialis brevis with the Pulvertaft technique. After five months of follow up, the patient finally can extend her wrist and thumb. Modified Jones procedure is a viable option to treat high radial nerve palsy with great functional outcomes after 5 months of follow up. •Fractures of the middle-distal parts of the humeral shaft can cause high radial nerve palsy•A tendon transfer surgery is essential to treat longstanding radial nerve palsies to improve the lost hand function•Modified jones procedure is a viable option in treatment with great functional outcomes after 5 months of follow up