Palmaris longus tendon transfer for augmentation of the thenar musculature in low median palsy.

The palmaris tendon may be lengthened by a distal strip of palmar fascia and transferred subcutaneously to the tendon of insertion of the abductor pollicis brevis for augmentation of thumbs elevation from the palm. The transfer attempts to duplicate abductor brevis function in the complex act of opposition. The palmaris has appropriate strength, excursion, and direction for this purpose. It is properly phased for pinch activity and requires minimal retraining. Twenty-eight cases of transfer have been performed successfully and without difficulty. The uses of the transfer have included cases of carpal tunnel syndrome with thenar atrophy, injury to thenar muscles, and direct trauma to the median nerve in the forearm.