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Palliative surgery for thumb involvement in ulnar paralysis.

A Cambon-Binder1, M Chammas2, B Coulet2

  • 1Service d'orthopédie et de chirurgie du membre supérieur, Hôpital Saint-Antoine, 184 Rue du Faubourg Saint-Antoine, 75012 Paris, France.

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Summary

Ulnar paralysis causes hand weakness and impaired finger function. Palliative surgery can restore hand strength by reinforcing thumb and finger movements when nerve repair is insufficient.

Keywords:
Chirurgie palliativeFlexor pollicis brevisPalliative surgeryParalysie du nerf ulnaireTendon transfersTransferts tendineuxUlnar nerve paralysis

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Area of Science:

  • Neurology
  • Orthopedic Surgery

Background:

  • Ulnar nerve paralysis presents with varied clinical signs due to nerve variations or partial recovery.
  • Key sequelae include hand weakness, intrinsic finger dysfunction, and thumb adductor/flexor deficits, impacting pinch strength.

Purpose of the Study:

  • To review the role and techniques of palliative surgery for ulnar nerve paralysis.
  • To describe surgical principles for reinforcing hand function when nerve repair is not feasible.

Main Methods:

  • Review of palliative surgical techniques for ulnar nerve paralysis.
  • Description of tendon transfer procedures to restore metacarpophalangeal flexion and thumb stability.

Main Results:

  • Palliative surgery remains indicated when nerve repair is not suitable or yields poor outcomes.
  • Tendon transfer of the flexor digitorum superficialis is a primary method to supplement weakened muscles.

Conclusions:

  • Palliative surgery effectively addresses functional deficits in ulnar paralysis.
  • Surgical reinforcement of metacarpophalangeal flexion and thumb stabilization improves hand strength and function.