[Reconstruction of thumb opposition function by transferring extensor carpi ulnaris and extensor pollicis brevis muscle tendons].

OBJECTIVE

To evaluate the results of thumb opposition function by transferring the extensor carpi ulnaris and the extensor pollicis brevis muscle tendons.

METHODS

Between March 2006 and August 2009, 35 patients with dysfunction of thumb opposition were treated and the thumb opposition function was reconstructed by transferring the extensor carpi ulnaris and the extensor pollicis brevis muscle tendons. There were 25 males and 10 females with an average age of 33.5 years (range, 20-53 years); 20 had median nerve injury in the wrist and 15 had median nerve injury with ulnar nerve injury. The causes were sharp instrument injury in 24 cases, blunt injury in 9 cases, and hot crush injury in 2 cases. Six cases complicated by shaft fractures of radius and ulna. All the patients underwent an operation of nerve repair at 1 to 3 hours after injury (mean, 2 hours). The time from injury to reconstructing operation was 6-14 months (mean, 7.5 months). Two cases was able to abduct thumb slightly, the others had no functions of thumb abduct and thumb opposition.

RESULTS

All the wounds gained the primary healing. The patients were followed up 12-18 months (mean, 14 months). The wrist joint angle and thumb dorsal extension were satisfactory. Thumb abduct and thumb opposition function returned to normal in 20 patients with simple median nerve injury; in 15 patients with median nerve injury and ulnar nerve injury, thumb abduct and thumb opposition function returned to normal in 15 and 13, respectively. According to ZHAO Shuqiang's standard, the results of thumb opposition function were normal in all patients at 12 months after operation.

CONCLUSION

It is a convenient and efficient procedure to reconstruct thumb opposition function by transferring the extensor carpi ulnaris and the extensor pollicis brevis muscle tendons.