Translocation of the flexor pollicis longus tendon to restore opposition.
نویسنده
چکیده
Many operations have been described to restore active opposition of the thumb, but all are dependent on the transplant of tendons and their rerouting to fulfil their new function. When there is no motor available for transplant-quite a common problem-the accepted procedure is to unite the first metacarpal bone to the second in the position of opposition. In 193 1 von Baeyer described a method of translocations of tendons whereby their origin and insertion were left intact but the tendon was rerouted to enable it to fulfil a different function. One of the operations he advocated was translocation of the flexor pollicis longus tendon to act as an opposer of the thumb. Von Baeyer recommended a circular incision around the thumb ; after the tendon of the flexor pollicis longus muscle had been freed it was looped over the tip of the thumb and wound around the proximal phalanx to oppose the thumb. In many cases the circular incision around the thumb caused necrosis of the distal part of the thumb and the operation fell into disrepute. My method embodies the principles oftranslocation ofthe flexor pollicis longus. It avoids the dangers of necrosis, is simple to perform and successful in restoring opposition. Opponens translocation is indicated when active opposition is lacking and when all the intrinsic muscles of the thumb are paralysed. The thumb should be freely mobile and there must be no contracture. To ensure a satisfactory result the power of the flexor pollicis longus muscle should be at least “ good “ (rated 4).
منابع مشابه
Inter-metacarpal Bone Graft for Thenar Paralysis
In 1930 Foerster described an operation for restoring opposition of the thumb in cases of paralysis of abductor brevis and opponens pollicis ; a bone graft was inserted between the first two metacarpals to maintain the thumb in palmar abduction and opposition. The method was elaborated by Thompson (1942) and the results in seven cases were reviewed. Both authors were satisfied that the function...
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ورودعنوان ژورنال:
- The Journal of bone and joint surgery. British volume
دوره 49 3 شماره
صفحات -
تاریخ انتشار 1967