Transposition of flexor pollicis brevis muscle for reconstruction of thumb opposition: a clinical report / 中华骨科杂志

ABSTRACT

Objective To introduce a new optimal operation for the reconstruction of thumb opposition in patients with late median nerve injury. Methods From July 1992 to January 2002, 46 patients of late median nerve injury with loss of thumb abduction were treated surgically by transposition of the flexor pollicis brevis muscle for the reconstruction of thumb opposition. There were 35 males and 11 females aging from 18 to 46 years with the average of 32 years. All of the patients suffered from median nerve injury and nerve repair had been undergone. The interval from injury to the second operation was 2.25 years ranging from 6 months to 4 years. Results All patients were followed up for 4-36 months with an average of 20 months. According to our functional evaluation system designed in 1992, the recovery ratio with favorable function was 100%, no complications and disadvantages were found. Conclusion The new optimal transpositional operation of the flexor pollicis brevis muscle for the reconstruction of thumb opposition is suitable for the patients with late median nerve injury, especially when the ulnar nerve branch to the deep head of the flexor pollicis brevis muscle is uninjured. This method has the following advantages 1) Minimal operative trauma, only a small incision is required in contrast to the conventional method that need multiple incisions; 2)No other tendon transposition is needed, it does not interfere with other functions of the hand; 3) Postoperatively, it is unnecessary to keep many neighbouring joints in extreme flexion position, except for the thumb in opposition position, movements of all fingers and the wrist are not restrained.