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Structured Motor Rehabilitation After Selective Nerve Transfers
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[Selective nerve transfers for thenar branch reconstruction].

Martin Aman1, Arne Böcker2, Ulrich Kneser2

  • 1Klinik für Hand‑, Plastische und Rekonstruktive Chirurgie - Schwerbrandverletztenzentrum, BG Unfallklinik, Klinik für Hand und Plastische Chirurgie der Universität Heidelberg, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen, Deutschland. martin.aman@bgu-ludwigshafen.de.

Operative Orthopadie Und Traumatologie
|December 5, 2020
PubMed
Summary

This study reconstructs thumb opposition using a selective nerve transfer from the abductor digiti minimi (ADM) muscle to the thenar motor branch. The procedure restores thumb opposition, improving grip and pinch strength.

Keywords:
Abductor digiti minimi muscle transferMicrosurgeryOppositionReinnervationThumb

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Area of Science:

  • Hand surgery
  • Microsurgery
  • Nerve reconstruction

Background:

  • Loss of thumb opposition due to median nerve injury significantly impairs hand function.
  • Restoring thumb opposition is crucial for regaining grip and pinch strength.

Purpose of the Study:

  • To describe a selective nerve transfer technique for reconstructing thumb opposition.
  • To evaluate the functional outcomes of this nerve transfer procedure.

Main Methods:

  • Microsurgical dissection and transfer of the motor branch of the abductor digiti minimi (ADM) muscle to the thenar motor branch.
  • Selective nerve transfer indicated for median nerve or thenar motor branch injuries.
  • Contraindications include combined nerve injuries or long-standing denervation (>12 months).

Main Results:

  • Successful reinnervation of the thenar muscles.
  • Restoration of thumb opposition.
  • Improved range of motion, grip, and pinch force.

Conclusions:

  • Selective nerve transfer of the ADM motor branch to the thenar branch is an effective method for reconstructing thumb opposition.
  • Postoperative management including regular follow-ups and physiotherapy is vital for optimal outcomes.
  • This technique offers a viable solution for patients with loss of thumb opposition due to nerve injury.