A modification in technique of abductor digiti minimi (Huber) opponensplasty

Abductor digiti minimi opponensplasty is a well-established method of restoring opposition following median nerve trauma or in congenital deficiency of thenar intrinsic musculature. The abductor digiti minimi is detached distally and rerouted through a subcutaneous tunnel for insertion into the area of the thumb metacarpophalangeal joint. The pivot point for this rotation is the pisiform bone and it is at this site that the ulnar nerve is vulnerable to compression by the transferred muscle. We describe a modification of technique which involves complete islanding of the muscle without re-insertion of its proximal end. This eliminates the possibility of this complication without detracting from the efficacy of opposition produced by the transferred muscle.