Comparison of Surgical Outcomes of Two Opponensplasty Techniques in Traumatic Isolated Low Median Nerve Palsy

Document Type : Original Article (s)

Authors

1 Associate Professor, Department of Orthopedic Surgery, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran

2 Assistant Professor, Department of Orthopedic Surgery, Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, Iran

3 Resident, Department of Orthopedic Surgery, Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Thumb opposition is a critical operation of thumb in human. Median nerve palsy interferes with many ordinary activities such as opposition. Opponensplasty for low median nerve injury is done with different techniques. This study aimed to compare tendon transfer techniques of Riordan and Burkhalter.Methods: This was a clinical-trial study on 40 patients underwent opponensplasty referred to Isfahan University of Medical Sciences hospitals, Iran, during 2013-16. Patients with traumatic low median nerve palsy were divided to two groups of Riordan and Burkhalter operation. Demographics, functional status, Kapandji score and, pulp pinching tests were conducted for all patients prior to surgery, and within 3 and 8 months after surgery.Findings: There was significant differences in both groups in terms of functional status, Kapandji score, and pulp pinching test (P < 0.050 for all), but comparison of two groups was not different (P > 0.050 for all). Complications of Riordan technique was significantly more than Burkhalter technique (P = 0.021).Conclusion: None of the Burkhalter or Riordan techniques was superior to the other one in terms of opposition recovery; but postsurgical complications of Burkhalter opponensplasty were fewer.

Keywords

References

  1. Azar FM, Canale T, Beaty JH. Campbell's operative orthopaedics. 13th ed. Philadelphia, PA: Elsevier; 2016.
  2. Schwarz RJ, Macdonald M. Assessment of results of opponensplasty. J Hand Surg Br 2003; 28(6): 593-6.
  3. Anderson GA, Lee V, Sundararaj GD. Extensor indicis proprius opponensplasty. J Hand Surg Br 1991; 16(3): 334-8.
  4. Anderson GA, Lee V, Sundararaj GD. Opponensplasty by extensor indicis and flexor digitorum superficialis tendon transfer. J Hand Surg Br 1992; 17(6): 611-4.
  5. Hattori Y, Doi K, Sakamoto S, Kumar K, Koide S. Camitz tendon transfer using flexor retinaculum as a pulley in advanced carpal tunnel syndrome. J Hand Surg Am 2014; 39(12): 2454-9.
  6. Naeem R, Lahiri A. Modified camitz opponensplasty for severe thenar wasting secondary to carpal tunnel syndrome: case series. J Hand Surg Am 2013; 38(4): 795-8.
  7. Lemonas P, Laing T, Ghorbanian S, Malahias M, Ragoowansi R. Extensor indicis proprius opponensplasty - the burkhalter revisited. J Hand Microsurg 2012; 4(2): 47-9.
  8. Lefevre-Colau MM, Poiraudeau S, Oberlin C, Demaille S, Fermanian J, Rannou F, et al. Reliability, validity, and responsiveness of the modified Kapandji index for assessment of functional mobility of the rheumatoid hand. Arch Phys Med Rehabil 2003; 84(7): 1032-8.
  9. Hook WE, Stanley JK. Assessment of thumb to index pulp to pulp pinch grip strengths. J Hand Surg Br 1986; 11(1): 91-2.
  10. Atroshi I, Gummesson C, Johnsson R, McCabe SJ, Ornstein E. Severe carpal tunnel syndrome potentially needing surgical treatment in a general population. J Hand Surg Am 2003; 28(4): 639-44.
  11. Kapandji A. Clinical test of apposition and counter-apposition of the thumb. Ann Chir Main 1986; 5(1): 67-73. [In French].
  12. Canale ST, Beaty JH. Campbell's operative orthopaedics. 12th ed. Philadelphia, PA: Mosby; 2012.
  13. Burkhalter W, Christensen RC, Brown P. Extensor indicis proprius opponensplasty. J Bone Joint Surg Am 1973; 55(4): 725-32.
  14. Palande DD. Opponensplasty in intrinsic-muscle paralysis of the thumb in leprosy. J Bone Joint Surg Am 1975; 57(4): 489-93.
  15. Skie MC, Parent T, Mudge K, Dai Q. Kinematic analysis of six different insertion sites for FDS opponensplasty. Hand (NY) 2010; 5(3): 261-6.
  16. Jafari D, Yeganeh A, Shariatzadeh H. Assessment of results of opponensplasty in patients in Shafa Rehabilitation Center between 1974-2005. Razi J Med Sci 2007; 14(55): 75-80. [In Persian].
  17. Al-Qattan MM. Extensor indicis proprius opponensplasty for isolated traumatic low median nerve palsy: A case series. Can J Plast Surg 2012; 20(4): 255-7.
  18. Elkashty SM. Evaluation of extensor indicis proprius opponensplasty for traumatic low median nerve palsy. Egypt J Plast Reconstr Surg 2016; 40(1): 23-6.
Journal of Isfahan Medical School
Volume 35, Issue 457 - Serial Number 457
November and December 2018
Pages 1714-1719

Files

History

  • Receive Date: 05 October 2017
  • Revise Date: 29 April 2024
  • Accept Date: 06 April 2022

Share

How to cite

Statistics