Purpose
There are several potential donor muscle–tendon units for a thumb opposition transfer.
The extensor carpi ulnaris (ECU) is useful when the more usual donor units are not
available. The technique and results of a simplified ECU opposition transfer elongated
with a free tendon graft are described.
Methods
Ten ECU opposition transfers were performed using this modification of Henderson technique
in 5 adults after complex trauma, 3 adults with median and ulnar nerve palsies, and
2 children with congenital hand differences.
Results
Seven patients achieved a Kapandji opposition score of 6 to the distal phalanx of
the small finger, and 3 patients achieved a Kapandji score of 5 to the distal phalanx
of the ring finger. None of the patients required a secondary tenolysis or developed
a radial deviation imbalance of their wrist.
Conclusions
This modification of the Henderson technique using ECU elongated with a free tendon
graft and inserted directly and only into the abductor pollicis brevis tendon is an
effective method of restoring opposition to the thumb, especially when other conventional
donor muscle–tendon units are not available.
Type of study/level of evidence
Therapeutic V.
Key words
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References
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Article info
Publication history
Published online: June 17, 2021
Accepted:
April 23,
2021
Received:
February 19,
2020
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2022 by the American Society for Surgery of the Hand. All rights reserved.
