The clinical application of thumb opposition reconstruction by modified extensor carpi ulnaris tendon and extensor pollicis brevis tendon combined transfer

Objective To evaluate the treatment outcomes of reconstructing thumb opposition function by modified combined transfer of extensor carpi ulnaris and extensor pollicis brevis. Methods Between April 2013 and February 2016, 19 cases of old median nerve injury were treated with modified transfer of extensor carpi ulnaris and extensor pollicis brevi to restore thumb opposition function. The surgical modifications included passing the extensor pollicis brevis muscle tendon through the insertion of the abductor pollicis brevis and suturing it there before tunneling it underneath the palmaris longus tendon and weaving it with the transferred extensor carpi ulnaris tendon. The palmaris longus served as a flexor retinaculum to avoid postoperative bowstring. Postoperative functional recoveries were evaluated and analyzed. Results All 19 patients were follow-up for 3 to 15 months postoperatively, the average time being 6.8 months. The functional assessment graded the results as excellent in 14 cases, good in 5 cases. Conclusion The modified combined transfer of the extensor carpi ulnaris and extensor pollicis brevis is simple, and is in accordance with the biomechanics of human thumb. It is an effective surgical procedure that is worth promoting. Key words: Median nerve; Tendon transfer; Thumb opposition function; Extensor carpi ulnaris tendon