[Restoration of opposition using the extensor pollicis longus. Apropos of 8 cases reviewed after 11 years].
Moutet and coll. had studied in 1986 a series of 16 cases of restoration of thumb opposition by extensor pollicis longus transfer onto abductor pollicis brevis through the inter osseous membrane. Eleven years follow-up revision of 8 of those 16 patients was performed by the authors. Indication of transfer was traumatic median nerve isolated palsy or associated to ulnar nerve palsy. Objective and subjective analysed parameters allowed to check the evolution of the transfer and to justify its indications. No transfer retraction has been noted in long term follow-up. The side effects of its removal (thumb retropulsion and MP extension defects) have minimum functional consequences. The opposition has been restored at the time of thenarians recovery and as well, each time the palsy was going on. In the cases where the thenarians recovered, the transfer became an antepulsion supply. The authors suggest to perform an opposition transfer, each time it is technically possible, in severe median nerve lesions, at the time of emergency operation.
Gerard
P
P
Unité de Chirurgie réparatrice, de la Main et des Brûlés, Hôpital A. Michallon, Grenoble.
Picard
F
F
Moutet
F
F
Guinard
D
D
de Soras
X
X
D000293:Adolescent; D000328:Adult; D005260:Female; D005384:Finger Joint / Q000503:physiopathology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000293:injuries / Q000601:surgery; D008662:Metacarpophalangeal Joint / Q000503:physiopathology; D009068:Movement; D010243:Paralysis / Q000601:surgery; D016059:Range of Motion, Articular / Q000502:physiology; D012086:Reoperation; D012399:Rotation; D013709:Tendon Transfer; D013933:Thumb / Q000293:injuries* / Q000503:physiopathology / Q000601:surgery*; D014459:Ulnar Nerve / Q000293:injuries / Q000601:surgery