Abductor digiti quinti opponensplasty

Area of Science:

• Hand surgery
• Reconstructive surgery
• Orthopedic surgery

Background:

• Opponensplasty is crucial for thumb function restoration.
• Various techniques exist, each with limitations.
• Intrinsic muscle deficits impair thumb opposition.

Purpose of the Study:

• To evaluate the efficacy of abductor digiti quinti neurovascular pedicle transfer for opponensplasty.
• To compare this technique with other opponensplasty methods.

Main Methods:

• Fifteen neurovascular pedicle transfers of the abductor digiti quinti to the proximal phalanx of the thumb were performed.
• Indications included median nerve injury, neurological disease, and thenar muscle absence.
• Patient outcomes were assessed based on viability and functional results.

Main Results:

• Fourteen of the fifteen transfers were viable.
• Twelve patients achieved excellent functional outcomes.
• Three failures were associated with inadequate release of thumb contractures.

Conclusions:

• Abductor digiti quinti neurovascular pedicle transfer is a highly effective opponensplasty.
• Advantages include intrinsic muscle replacement, automatic tensioning, and superior aesthetics.
• Adequate release of thumb contractures is critical for success.