Opponensplasty / 대한정형외과학회잡지

ABSTRACT

Opposition of the thumb is necessary for pinch-one of the three most important functions of the hand. Frequently, opposition is either partially or totally lost in poliomyelitis or median nerve palsy. Several types of operations have been devised for restoration of opposition, and in 1973, Burkhalter et al. announced extensor indicis proprius opponensplasty the tendon of extensor indicis proprius is brought out in the area of the pisiform and then passed against subcutaneously across the palm to the thumb, being attached to the abductor pollicis brevis and extensor pollicis longus tendon. It is useful in the case of loss of opposition without available finger flexor or wrist motors. Of nine patients who underwent operation-one with Riordan and eight with Burkhalter type of opponensplasty-at National Medical Center, seven had excellent results: one had a fair, and another one had a poor result. Six patients were with low combined median and ulnar nerve injury one with high combined median and ulnar nerve injury one with brachial plexus injury and one with myotmesis of the thenar muscles. From the results, we conclude that Burkhalter type of opponensplasty makes satisfactory result for the hand without opposition movement; it is indicated in high median nerve injury and any combined median and ulnar nerve injury6; early restoration of opposition to the thumb in median nerve injury and in those limbs with multiple tissue trauma adds immeasurably to the over-all early rehabilitative effort.