Journal of Hand Surgery
Volume 29, Issue 4 , Pages 625-627, July 2004

Unusual complication of an opposition tendon transfer at the wrist: ulnar nerve compression syndrome☆

  • Jean-Paul Brutus, MD

      Affiliations

    • Corresponding Author InformationReprint requests: J. P. Brutus, MD, Department of Orthopedic Surgery, Upstate New York Medical University, 550 Harrison St, Syracuse, NY 13202 USA
    • Department of Orthopedic Surgery, Upstate New York Medical University, Syracuse, NY, USA
    • ,
  • Jessica A Mattoli, MD

      Affiliations

    • Department of Orthopedic Surgery, Upstate New York Medical University, Syracuse, NY, USA
    • ,
  • Andrew K Palmer, MD

      Affiliations

    • Department of Orthopedic Surgery, Upstate New York Medical University, Syracuse, NY, USA

Received 2 October 2003; accepted 24 February 2004.

Abstract 

Restoration of thumb opposition by tendon transfer may be necessary in cases of severe thenar atrophy caused by long-standing carpal tunnel syndrome. Routing the extensor indicis proprius transfer subcutaneously around the ulna to reanimate thumb opposition is an accepted procedure and is considered safe. Ulnar nerve compression leading to palsy is possible, however, as shown in the patient presented. Neurolysis failed to improve the palsy. Rerouting of the transfer deep to the ulnar nerve was necessary to treat the iatrogenic condition. Possible nerve compression should be kept in mind when planning a tendon transfer around the ulnar side of the forearm or carpus and when following up with the patient. Early intervention is necessary to prevent permanent sequelae.

Keywords:  Thumb opposition, ulnar nerve compression, tendon transfer, complication

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☆ No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

PII: S0363-5023(04)00206-0

doi:10.1016/j.jhsa.2004.03.001

Journal of Hand Surgery
Volume 29, Issue 4 , Pages 625-627, July 2004

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