Bilateral opponens replacement in post polio thenar paralysis, using different techniques. A case report

Area of Science:

• Hand surgery
• Neuromuscular disease rehabilitation
• Microsurgery

Background:

• Poliomyelitis can lead to significant upper extremity paralysis, particularly affecting hand function.
• Thenar muscle paralysis results in loss of thumb opposition, severely impairing hand utility.
• Restoring thumb function is crucial for regaining prehensile capabilities.

Observation:

• A patient presented with bilateral thenar paralysis secondary to poliomyelitis.
• Initial surgical intervention on the right hand involved an abductor digiti minimi transfer.
• The left hand exhibited hypothenar muscle weakness, complicating initial surgical outcomes.

Findings:

• The abductor digiti minimi transfer on the right hand resulted in a successful restoration of function.
• Weakness in the hypothenar muscles of the left hand limited the success of the initial procedure.
• A subsequent opponens replacement using the flexor digitorum superficialis from the ring finger achieved a favorable outcome on the left hand.

Implications:

• Surgical reconstruction techniques can effectively address thenar paralysis caused by poliomyelitis.
• The choice of surgical procedure should consider the specific muscle deficits present.
• Restoring thumb opposition through tendon transfers is a viable strategy for improving hand function in paralytic conditions.