Opponensplasty Using the Extensor Digiti Minimi

¹ From the Division of Orthopedic Surgery, State University of New York, Downstate Medical Center, Brooklyn

It is conceded that a solitary tendon transfer cannot be expected to completely restore all aspects of the complex, integrated function of opposition; however, a review of the results obtained in this small series of patients suggests that this procedure can reliably restore useful opposition to the thumb. This operation has certain advantages over the standard procedures which utilize the superficial finger flexors or wrist flexors as motors:

1. The construction of the pulley mechanism is unnecessary;

2. The length of the tendon to be transferred is adequate and there is no need for addition of a tendon graft;

3. There is no need to violate the delicate flexor mechanism as when the flexor superficialis is used as a motor, a procedure not without hazard. ^5,15

Success using this transfer in this small series of patients has prompted its use even in patients with available superficial flexor motors. Two additional patients, both with absent thenar group muscles (one secondary to trauma, the other congenital) have undergone this procedure and have achieved good results in the early follow-up period.

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