Huber Abductorplasty for Thenar Atrophy: Revisiting an Overlooked Adult Indication

Area of Science:

• Hand surgery
• Reconstructive surgery
• Orthopedics

Background:

• Restoring thumb abduction is crucial for hand function in patients with thenar atrophy.
• The abductor digiti minimi (Huber) transfer is infrequently utilized in adult populations for thumb abduction reconstruction.
• This study investigates the functional outcomes of Huber abductorplasty in adult patients.

Purpose of the Study:

• To evaluate the postoperative functional results of Huber abductorplasty in adult patients.
• To compare outcomes with contralateral hand function and published normative data.
• To assess the viability of Huber abductorplasty as a reconstructive option for thenar atrophy in adults.

Main Methods:

• Four adult patients (20-39 years) with thenar atrophy underwent Huber abductorplasty.
• Etiologies included iatrogenic nerve injury, traumatic nerve laceration, and thoracic outlet syndrome.
• Outcomes measured included Disabilities of the Arm, Shoulder, and Hand (DASH) scores, pain, range of motion, and pinch/grasp strength.

Main Results:

• Three out of four patients showed improved DASH scores, with one experiencing persistent disability.
• Pain resolved in most patients within two months.
• Thumb strength measures (3-jaw pinch, lateral pinch, gross grasp) showed variable recovery compared to normative values.

Conclusions:

• Huber abductorplasty can achieve meaningful functional recovery and improve thenar contour in select adult patients.
• This technique is a viable reconstructive choice for thenar atrophy.
• The procedure warrants consideration alongside other opponensplasty techniques in adults.