An operative procedure for functional repair of thumb opposition is described. The extensor pollicis brevis is displaced to the proximal two-thirds of the carpal canal without detachment of its distal end. Twelve patients with combined lesions of the median and ulnar nerve were operated on. Ten patients were followed up from one to six years after the intervention. Restoration of thumb opposition to the middle or to the ring finger was observed in all, in three cases without sufficient pronation.
Get full access to this article
View all access options for this article.
References
1.
ANSONB. J. (1963) An Atlas of Human Anatomy.W. B. Saunders Co., Philadelphia.
2.
BUNNELLS. (1948) Surgery of the Hand.Second Edition, Philadelphia, J. B. Lippincott Company.
3.
DUPARCJ., CAFFINIERE de laJ. Y.et ROUXJ. P. (1971) Les plasties d'opposition par transplantation tendineuse á traverse la membrane inter-osseuse.Revue de Chirurgie Orthopedique et reparatrice de l'appareil noteur, 57: 29–34.
4.
EDGERTONM. T., and BRANDP. W. (1965) Restoration of Abduction and Adduction to the Unstable Thumb in Median and Ulnar Paralysis.Plastic and Reconstructive Surgery, 36: 150–164.
5.
ENNAC. D. (1970) use of the Extensor Pollicis Brevis to Restore Abduction in the Unstable Thumb.Plastic and Reconstructive Surgery, 46: 350–356.
6.
IRWINC. E., and EYLERD. L. (1951) Surgical Rehabilitation of the Hand and Forearm Disabled by Poliomyelitis.The Journal of Bone and Joint Surgery, 33A: 825–835.
7.
KARAGANCHEVAS. (1973) Thumb opposition in total lesion of the median nerve.Ortopedia i Travmatologia, 10: 233–234.
8.
KANEFFA. (1959) über die Evolution des M. abductor pollicis longus und M. extensor pollicis brevis. Mitteilungen des Morphol.Institat der Bulgarischen Akademie der Wissenschaften, 3: 175–196.
9.
KESSLERI. (1969) Transfer of Extensor Carpi Ulnaris to Tendon of Extensor Pollicis Brevis for Opponensplasty.The Journal of Bone and Joint Surgery, 51A: 1303–1308.
10.
MASAKAA. B. (1954) The Accessory Tendon of the Abductor Pollicis Longus Muscle.The Anatomical Record, 119: 541–547.
11.
MATEVI. (1974) Functional repair of thumb opposition by extensor pollicis brevis displacement.Ortopedia i Travmatologia, 11: 73–78.
12.
MERLE d'AUBIGNéR., and VALENTINP. (1965) Résultat de réparations tronculaires de médian et de cubital.Memoires de l'Academie de Chirurgie, 91: 743–755.
13.
ORTICOCHEAM. (1971) Use of the Deep Bundle of the Flexor Pollicis Brevis to Restore Opposition in the Thumb.Plastic and Reconstructive Surgery, 47: 220–224.
14.
SALAE. (1959) Studio electromiografico dell'innervazione dei muscoli flessore breve ed opponente del pollice.Rivista de Patologia Nervosa E Mentale, 80: 131–147.
15.
SCHNEIDERL. H. (1969) Opponensplasty using the Extensor Digiti Minimi.The Journal of Bone and Joint Surgery, 51A: 1297–1302.
16.
SNOWJ. W., and FINKG. H. (1971) Use of a Transverse Carpal Ligament Window for the Pulley in Tendon Transfers for Median Nerve Palsy.Plastic and Reconstructive Surgery, 48: 238–240.
17.
STEINA. H.Jr. (1951) Variations of the Tendons of Insertion of the Abductor Pollicis Longus and the Extensor Pollicis Brevis.The Anatomical Record, 110: 49–55.
18.
TUBIANAR. (1969) Anatomic and Physiologic Basis for the Surgical Treatment of Paralyses of the Hand.The Journal of Bone and Joint Surgery, 51A: 643–660.
19.
ZANCOLLIE. (1965) Tendon Transfers after Ischemic Contracture of the Forearm. Classification in Relation to Intrinsic Muscle Disorders.The American Journal of Surgery, 109: 356–360.