Flexor Superficialis Abductor Transfer With Carpal Tunnel Release for Thenar Palsy

Richer, Ross J.; Peimer, Clayton A.

doi:10.1016/j.jhsa.2004.12.010

Cited by 27 publications

(13 citation statements)

References 34 publications

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“…12 All cited the MRC (although Leechavengvongs et al 10,11 did not cite an original MRC publication), but all modified its intended use by presenting only preoperative data 5,8 ; reporting only "average increase of British Medical Research Council units" 12 ; subdividing grade 4 into 4 -, 4, and 4ϩ 5 ; adding together the scores of muscles sharing the innervation of a peripheral nerve to create a composite score 6 ; describing deltoid function as grade 4 without full shoulder abduction against gravity 9,11 ; or eliminating grades 4 and 5 but expanding grades 2 and 3. 7 Of all these recent Journal of Hand Surgery publications, only Chen et al 9 and Curtis et al 7 note that they have used a modified version of the MRC, and only Curtis et al 7 formally validated their modification, the Active Movement Scale, by studying interrater reliability.…”

Section: Modifications Of the Mrcmentioning

confidence: 99%

Use of the Medical Research Council Muscle Strength Grading System in the Upper Extremity

James

2007

The Journal of Hand Surgery

165

107

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Section: Modifications Of the Mrcmentioning

confidence: 99%

Use of the Medical Research Council Muscle Strength Grading System in the Upper Extremity

James

2007

The Journal of Hand Surgery

165

107

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“…The pronation of thumb was the most difficult to be restored. Troublesome complications could arise such as flexion contracture of the donor finger when the flexor superficialis was removed 4. Theoretically, transfer of intrinsic muscles to replace lost thenar muscles is more advantageous than the tendon transfer.…”

Section: Discussionmentioning

confidence: 99%

“…Reconstruction of thumb opposition is usually carried out with tendon or muscle transfer. The donor of tendon includes the palmaris longus,2, 3 the flexor superficialis,4 the extensor indicis proprius,5 the extensor pollicis longus,6 or one of the wrist extensors 7. Intrinsic muscles of the hand, such as the abductor digiti quinti, have also been utilized for reconstruction, especially in children 8.…”

mentioning

confidence: 99%

Functional pectoralis minor muscle flap transplantation for reconstruction of thumb opposition: An anatomic study and clinical applications

Zhuang

Xiong

et al. 2011

Microsurgery

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In this report, we present the results of an anatomic study on the dimensions of the pectoralis minor muscle and its neurovascular supply in 10 adult human cadavers, in attempt to evaluate the feasibility of microsurgical transplantation of a part of the muscle for thumb opposition reconstruction. A series of five patients consequently underwent thenar reconstruction with the pectoralis minor muscle flap from December 2004 to October 2006. The transferred muscle was reinnervated with the third lumbrical branch of the ulnar nerve. Follow-up assessment showed that the patients recovered functional opposition of carpometacarpal joint with 24 degrees of pronation, and a muscle power with M4 to M5. All patients were satisfied with the appearance of reconstructed thenar eminence. We recommend this new technique for thenar and opposition reconstruction in patients who have severe loss of thenar muscles, injury to the median nerve, and wish to improve the appearance of thenar eminence.

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“…Richer et al, [11] evaluated the results of transfer of the FDS to the abductor pollicis brevis for restoration of thumb abduction in thenar paralysis caused by advanced chronic Carpal Tunnel Syndrome (CTS) and found satisfactory results for patients with profound CTS and thenar paralysis. The use of the little finger superficialis as the donor motor has minor morbidity compared with other methods and has predictable improvement and patient satisfaction.…”

Section: Evolution Of Flexor Digitorum Superflcialismentioning

confidence: 99%

Bilateral Absence of Flexor Digitorum Superficialis Tendon of the Little Finger: Clinical Significance

Gupta

Kumar

2014

JCDR

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The flexor digitorum superficialis (FDS/sublimis) is a flexor of the digits of the hand and has been reported to have varying degrees of agenesis. During routine cadaveric dissection for undergraduates at SRMS-IMS Bareilly, India, we observed bilateral absence of the FDS tendon to little finger in the upper limbs of a 45-year-old male cadaver. The muscle was normally supplied by a branch of median nerve in the forearm. Variants of the FDS muscle of the little finger have been reported in the literature. Proper knowledge of muscular variations is essential not only for anatomists but also for orthosurgeons, plastic surgeons and neurologists especially when evaluating possible tendon laceration/dysfunction. The FDS has been used as a motor for a wide variety of tendon transfer operations in the hand. CASE REPORTDuring routine dissection of the front of the forearm for undergraduate teaching in the Department of Anatomy, SRMS-IMS, Bareilly, India, we observed bilateral absence of the FDS tendon to the little finger in the upper limbs of a 45-year-old male cadaver. The muscles of the flexor compartment of both limbs were carefully dissected using Cunningham's Manual of Anatomy. After stepwise dissection of the front of forearm, we found the normal origin of the muscle by two heads, viz., humero-ulnar and radial head. A branch of median nerve supplied the muscle. The FDS divided distally into 3 tendons (instead of 4) for the ring, middle and index fingers. Relationship with neighbouring structures was found normal and no other associated abnormalities were noticed. Also, no other variation was noted in the course and insertion of the remaining FDS tendons [Table/ Fig-1 and 2]. The Flexor digitorum profundus (FDP) tendon for the little finger remains interconnected with ring and middle finger tendon (except for index finger tendon which seperates early) in the forearm. In the palm, it passes normally through perforated FDS tendon and is inserted to the base of terminal phalanx.

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Flexor Superficialis Abductor Transfer With Carpal Tunnel Release for Thenar Palsy

Cited by 27 publications

References 34 publications

Use of the Medical Research Council Muscle Strength Grading System in the Upper Extremity

Use of the Medical Research Council Muscle Strength Grading System in the Upper Extremity

Functional pectoralis minor muscle flap transplantation for reconstruction of thumb opposition: An anatomic study and clinical applications

Bilateral Absence of Flexor Digitorum Superficialis Tendon of the Little Finger: Clinical Significance

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