A case of mirror hand in which there were four supernumerary fingers but in which the lateral forearm bone exhibited many of the features of a radius is described. Observation showed that, in this case, the supernumary index finger was the most suitable for thumb construction. Rotation osteotomy of the metacarpal of this finger combined with opposition tendon transfer resulted in the creation of an efficient, opposable thumb, but transfer of a finger extensor tendon to the dorsum of the wrist did not produce lasting benefit.
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