Restoration of pinch in ulnar nerve palsy by transfer of split extensor digiti minimi and extensor indicis

Subcutaneous transfer of the ulnar slip of the extensor digiti minimi (EDM) to the adductor tubercle across the dorsum of the hand restores pinch, and index finger abduction is reproduced by re-routing extensor indicis proprius around the thumb extensor tendons. Six patients with post-traumatic ulnar palsy have been treated by this method with a minimum follow-up period of 40 months. Pinch was improved from an average of 5% to 40-50% of the normal side, and index abduction to 30-40%. There was no donor morbidity.