Camitz palmaris longus abductorplasty for severe thenar atrophy secondary to carpal tunnel syndrome

Terrono, Andrew L.; Rose, Joan H.; Mulroy, John; Millender, Lewis H.

doi:10.1016/0363-5023(93)90346-5

Cited by 46 publications

(44 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…One might assume that the majority of patients would be satisfied after CTR alone but it is well documented and reasonable to believe that CTR and simultaneous abductor transfer act synergistically in their ability to produce functional improvement. 15 In the long term the abduction strength in our patients increased markedly, as did active thumb abduction, and later many experienced the addition of some thenar muscle recovery. Intuitively, early thumb abduction depends entirely on the transfer; however, by 12 months it is improved further by APB reinnervation when that occurs.…”

Section: Discussionmentioning

confidence: 94%

“…In articles in which abductor transfers are discussed, attention was focused generally on the Camitz 20 procedure of transfer of the palmaris longus prolonged with palmar fascia to the APB. 11,15 Our own experience with the Camitz transfer led us to begin using the FDS transfer. Although both the Camitz and FDS abductor transfers theoretically achieve a similar functional result, the large midpalmar incision necessary for the Camitz transfer left many of our patients complaining of the scar, scar tenderness, and discomfort that made the improvement in abduction much less gratifying than anticipated.…”

Section: Discussionmentioning

confidence: 99%

“…12,13 For the small subset of patients with advanced CTS and notable dysfunction from thenar muscle paralysis, abductor transfer long has been considered a logical adjunct to CTR to improve opposition and hand function. 9,11,15 Numerous studies 11,[15][16][17][18][19] have described procedures for restoration of abduction for isolated thenar paralysis, most commonly using the palmaris longus prolonged by palmar fascia as originated by Camitz. 20 Since Codavilla in 1890 described the principles underlying the transfer of the ring finger flexor digitorum superficialis (FDS) into the thumb to produce active abduction, however, few 1,21 have addressed specifically abductor transfer using an FDS motor into the APB.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Flexor Superficialis Abductor Transfer With Carpal Tunnel Release for Thenar Palsy

Richer¹,

Peimer²

2005

The Journal of Hand Surgery

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Flexor Superficialis Abductor Transfer With Carpal Tunnel Release for Thenar Palsy

Richer¹,

Peimer²

2005

The Journal of Hand Surgery

View full text Add to dashboard Cite

“…7,12) As such, despite the full regaining of thenar bulk and motor innervation, the six patients still use the PL in the execution of thumb opposition and abduction: moderate PL recruitment was noted in three and abundant PL muscle activity was seen in the other three. Thus, even when the thenar muscles have recovered, the PL continues to serve its purpose.…”

Section: Discussionmentioning

confidence: 99%

Thumb Function and Electromyography Result after Modified Camitz Tendon Transfer

Durban

Antolin

et al. 2017

J Hand Surg Asian-Pac Vol

View full text Add to dashboard Cite

Background: Various techniques of opponensplasty have been developed with the aim of restoring the thumb function. The modified Camitz opponensplasty is a simple technique done together with an open carpal tunnel release. It restores thumb palmar abduction soon after the procedure, during such time that the abductor pollicis brevis (APB) is still recovering. The aim of this study was to assess the recovery and level of activity of the abductor pollicis brevis and palmaris longus (PL) muscles during thumb opposition and abduction after performing the modified Camitz opponensplasty. Methods: The records of 21 patients who underwent modified Camitz opponensplasty for severe carpal tunnel syndrome were reviewed. Thumb function was evaluated using the Van Wetter Apogee test, Kapandji index, tripod pinch strength, and power grip. Electromyography was utilized to evaluate APB recovery; ultrasonography was employed to evaluate PL activity. Results: Twenty patients reached 80% of the abduction height of the contralateral hand; the Kapandji index was good in thirteen. Palmaris longus activity was evaluated together with the APB muscle recovery. There was significant improvement in the average grip strength and average tripod pinch strength. However, this did not correlate with the degree of neurologic and muscular recovery of the APB. We surmise that the palmaris longus augmented the abductor pollicis brevis muscle even in those with full muscle recovery. Conclusions: The modified Camitz opponensplasty is a practical option for patients suffering from severe carpal tunnel syndrome with diminished thumb function.

show abstract

“…In thenar paralysis, restoration of function can be achieved by several surgical approaches involving PL tendon transfer to the insertion site of the abductor pollicis brevis to restore thumb abduction function (Camitz Opponensplasty) (Camitz, ; Rymer and Thomas, ). A modified approach to Camitz opponensplasty in treatment of severe carpal tunnel syndrome mobilizes the PL tendon through the radial or ulnar portion of the incised flexor retinaculum for use as a pulley for better approximation of pure opposition movements (Foucher et al ; Kato et al ; Littler and Li, ; Macdougal, ; Park et al ; Terrono et al ). Although the site of the PL insertion is transferred from the wrist to the interphalangeal joint of the first digit, patients require no specific rehabilitation perhaps due to an established neuromuscular facilitation, or synergy, already existing between the PL and abductor pollicis brevis (Kato et al ).…”

Section: Discussionmentioning

confidence: 99%

Revisiting the functional anatomy of the palmaris longus as a thenar synergist

2017

View full text Add to dashboard Cite

Surgical studies describe the palmaris longus (PL) as a synergist in thumb abduction, which may facilitate its use in restoring thumb function using opponensplasty. However, beyond morphological descriptions and isometric thenar abduction strength measures, the evidence supporting the PL as a thenar synergist in-vivo is limited. The purpose here was to determine whether the PL provides synergistic contributions to thenar musculature by: (1) recording PL muscle activity using indwelling electromyography (EMG) during thumb movements; and (2) quantifying changes in PL muscle architecture using ultrasonography. In 10 healthy males, PL muscle activity was recorded during maximal thenar muscle contractions (abduction, flexion, opposition, adduction, and extension) with the wrist secured in a neutral position. The PL EMG was normalized to its maximal EMG recorded during isometric wrist flexion. Dynamic changes in PL muscle thickness (M ) were determined during abduction and adduction using ultrasound imaging. The results indicate that the PL is activated during thenar movements with greatest relative PL EMG recorded during thenar abduction (46%), flexion (35%) and opposition (37%). Compared to rest, PL M significantly increased (21%) during maximal thenar abduction. With direct measures in vivo, this study supports morphological and surgical observations indicating the PL acts as an extrinsic hand muscle in enhancing thenar muscle actions. Knowledge of the synergistic relationship between the PL and thenar musculature may allow for further development of surgical opponensplasty approaches using the abductor pollicis brevis and PL as a functional digastric unit. Clin. Anat. 31:760-770, 2018. © 2017 Wiley Periodicals, Inc.

show abstract

Camitz palmaris longus abductorplasty for severe thenar atrophy secondary to carpal tunnel syndrome

Cited by 46 publications

References 3 publications

Flexor Superficialis Abductor Transfer With Carpal Tunnel Release for Thenar Palsy

Flexor Superficialis Abductor Transfer With Carpal Tunnel Release for Thenar Palsy

Thumb Function and Electromyography Result after Modified Camitz Tendon Transfer

Revisiting the functional anatomy of the palmaris longus as a thenar synergist

Contact Info

Product

Resources

About