Extensor indicis proprius opponensplasty - the burkhalter revisited

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Reconstructive Surgery

Background:

• The Extensor Indicis Proprius Opponensplasty is an underutilized technique for thumb opposition restoration.
• It has demonstrated good functional outcomes in prior studies.
• This study explores its use as an alternative to the Flexor Digitorum Superficialis.

Purpose of the Study:

• To evaluate the functional outcomes and donor site morbidity of the Extensor Indicis Proprius Opponensplasty.
• To compare its efficacy with the Flexor Digitorum Superficialis for thumb opposition.

Main Methods:

• A case series of six male patients (average age 32) underwent Extensor Indicis Proprius Opponensplasty.
• Follow-up was conducted over 12 months.
• The Extensor Indicis Proprius tendon was selectively used when the Flexor Digitorum Superficialis was unavailable or unsuitable.

Main Results:

• The procedure yielded impressive functional outcomes in the patient cohort.
• Minimal donor site morbidity was observed.
• The Extensor Indicis Proprius demonstrated a favorable line of pull and torque, offering mechanical advantages.

Conclusions:

• The Extensor Indicis Proprius is an expendable tendon with minimal donor site morbidity.
• It provides a superior mechanical advantage and favorable torque for thumb opposition compared to the Flexor Digitorum Superficialis.
• This technique is a valuable option in reconstructive hand surgery.