Flexor pollicis longus reconstruction using the palmaris longus in anterior interosseus nerve syndrome

In anterior interosseus nerve syndrome, reconstruction of the paralyzed flexor pollicis longus is occasionally required. Traditionally, the brachioradialis has been used as a motor, but we utilised the palmaris longus, which is expendable. The palmaris longus tendon was transferred in an end-to-side manner, leaving the flexor pollicis longus in situ. The procedure was performed in three patients. All patients regained a full range of thumb interphalangeal joint motion and an average 90% of the pinch strength. The only complication noted was thenar pain due to the adhesion of the palmar branch of the median nerve with the transferred tendon in one patient. This can be avoided if the interlacing suture was placed more proximally. Palmaris longus transfer is a simple technique that gives a satisfactory result.