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Cambon-Binder A, Chammas M, Coulet B, et al. Palliative surgery for thumb involvement in ulnar paralysis. Hand Surg Rehabil. 2021;doi: 10.1016/j.hansur.2020.10.021.
Cambon-Binder, A., Chammas, M., Coulet, B., & Lazerges, C. (2021). Palliative surgery for thumb involvement in ulnar paralysis. Hand surgery & rehabilitation, . https://doi.org/10.1016/j.hansur.2020.10.021
Cambon-Binder, A, et al. "Palliative surgery for thumb involvement in ulnar paralysis." Hand surgery & rehabilitation vol. (2021). doi: https://doi.org/10.1016/j.hansur.2020.10.021
Cambon-Binder A, Chammas M, Coulet B, Lazerges C. Palliative surgery for thumb involvement in ulnar paralysis. Hand Surg Rehabil. 2021 Jul 01; doi: 10.1016/j.hansur.2020.10.021. Epub 2021 Jul 01. PMID: 34217899.
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Hand Surg Rehabil. 2021 Jul 01; doi: 10.1016/j.hansur.2020.10.021. Epub 2021 Jul 01.

Palliative surgery for thumb involvement in ulnar paralysis.

Hand surgery & rehabilitation

A Cambon-Binder, M Chammas, B Coulet, C Lazerges

Affiliations

  1. Service d'orthopédie et de chirurgie du membre supérieur, Hôpital Saint-Antoine, 184 Rue du Faubourg Saint-Antoine, 75012 Paris, France.
  2. Service de chirurgie de la main et du membre supérieur, chirurgie des nerfs périphériques Hôpital Lapeyronie, CHU Montpellier, CHU Montpellier, Avenue du doyen Gaston Giraud, 34295 Montpellier Cedex 5, France. Electronic address: [email protected].
  3. Service de chirurgie de la main et du membre supérieur, chirurgie des nerfs périphériques Hôpital Lapeyronie, CHU Montpellier, CHU Montpellier, Avenue du doyen Gaston Giraud, 34295 Montpellier Cedex 5, France.

PMID: 34217899 DOI: 10.1016/j.hansur.2020.10.021

Abstract

Ulnar paralysis has multiple clinical presentations, which are due to partial recovery or to anatomical variations between the ulnar and median nerves. The main sequelae of ulnar nerve paralysis are the loss of hand strength with impairment of all intrinsic functions of the fingers and some of the thumb's functions. Weakness of the adductor pollicis and flexor pollicis brevis muscles may manifest as weak key pinch with automatic flexion of the thumb interphalangeal joint when gripping. Indications for palliative surgery have decreased due to advances in peripheral nerve surgery. However, palliative surgery still has a significant role to play when nerve repair techniques are not indicated or do not provide satisfactory results. The principle is to reinforce metacarpophalangeal flexion while stabilizing the thumb's interphalangeal joint, thus supplementing the action of the flexor pollicis brevis. This is generally done by transferring the flexor digitorum superficialis tendon of the fourth finger to the distal insertion of the superficial thenar muscles and the extensor pollicis longus. Restoration of the first dorsal interosseous is more rarely indicated.

Copyright © 2021. Published by Elsevier Masson SAS.

Keywords: Chirurgie palliative; Flexor pollicis brevis; Palliative surgery; Paralysie du nerf ulnaire; Tendon transfers; Transferts tendineux; Ulnar nerve paralysis

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