Journal List > J Korean Orthop Assoc > v.32(4) > 1113446

Chung, Baek, Park, and Yoo: Oppeonensplasty in Patients with Nerve Injury or Congenital Hypoplasia of Thumb

Abstract

The purpose of this study was to evaluate the results of various types of opponensplasties which have been performed for the last 15 years. For the patients who had median nerve injury with or without ulnar nerve injury, we usually transferred the ECRL or ECRB to restore thumb opposition and Huber s procedure were usually done for thumb hypoplasia. With the criteria outlined by Sundararaj and Mani, postoperative function of 27 hands from 23 patients who underwent the opponensplasty from March 1981 to March 1995 were evaluated. The results from each etiology group were analyzed by the same criteria. Also subjective opinion of the patients about the scar were investigated by our own criteria. The analysis from overall 27 hands yielded 19 excellent (70.4%), 4 good (14.8%), 3 fair (11.1%), and 1 poor (3.7%) results with Sundararaj and Mani s criteria and 1 excellent (3.7%), 14 good (81.5%), 3 fair (11.1%), and 1 poor (3.7%) results about the scar. In 11 patients with nerve injury (median nerve with or without ulnar nerve injury), 7 excellent and 2 fair results were yielded by the ECRL or ECRB transfer, 1 excellent by Phalen-Miller's procedure, and 1 excellent by Burkhalter's procedure. In 8 patients with congenital hypoplastic thumb, 7 excellent results were yielded by Huber's procedure and 1 excellent by the ECRB transfer. In 8 patients with residual poliomyelitis or brachial plexus injury, the ECRB transfer yielded 3 excellent results. However, 2 good and 1 fair results were obtained by Bunnell's procedure; and l good, l poor by Camitz's procedure. In summary, the ECRL or ECRB transfer in the patients who had neuropathy, such as median with or without ulnar nerve injury, brachial plexus injury or residual poliomyelitis; and Huber's procedure in congenital hypoplastic thumb were thought to be one of the useful methods for the restoration of the thumb opposition.

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