Abductor pollicis longus transfer for replacement of first dorsal interosseous

One of the tendinous slips of the abductor pollicis longus has been used to replace the first dorsal interosseous. One of the slips which does not insert on the first metacarpal is prolonged by a tendon graft through a subcutaneous tunnel to the insertion of the first dorsal interosseous. This technique has been used in 18 patients who have been followed from 2 to 12 years. All patients had improved stability in pinch, were able to abduct and to flex the index finger independently, and were satisfied with the results. No significant complications were encountered.