Modified Camitz Opponensplasty for Severe Thenar Wasting Secondary to Carpal Tunnel Syndrome: Case Series

Naeem, R.; Lahiri, A.

doi:10.1016/j.jhsa.2013.01.027

Cited by 25 publications

(47 citation statements)

References 7 publications

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“…Thenar muscle atrophy, especially abductor pollicis brevis (APB) atrophy, is frequently observed in patients with long-standing severe carpal tunnel syndrome (CTS). [1][2][3][4][5][6][7][8][9][10][11][12] Moreover, most advanced CTS patients with thenar muscle atrophy have severe disorder of thumb opposition and difficulty with activities of daily living. [1][2][3][4][5][6][7][8][9][10][11][12] Thumb opposition is essential in providing motion and strength for both pinch and grasp, and, therefore, it is important to restore it for these CTS patients.…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8][9][10][11][12] Moreover, most advanced CTS patients with thenar muscle atrophy have severe disorder of thumb opposition and difficulty with activities of daily living. [1][2][3][4][5][6][7][8][9][10][11][12] Thumb opposition is essential in providing motion and strength for both pinch and grasp, and, therefore, it is important to restore it for these CTS patients. [1][2][3][4][5][6][7][8][9][10][11][12] Opponensplasty is a standard and effective procedure that improves thumb opposition to achieve fine finger movement.…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8][9][10][11][12] Opponensplasty is a standard and effective procedure that improves thumb opposition to achieve fine finger movement. [1][2][3][4][5][6][7][8][9][10][11][12] Presently, various methods of opponespalsty have been reported. [13][14][15][16][17][18] Especially, the Camitz opponensplasty using the palmaris longus (PL) is the most commonly employed tendon transfer for severe CTS patients with distinct significant thenar muscle atrophy and loss of thumb opposition.…”

Section: Introductionmentioning

confidence: 99%

“…[13][14][15][16][17][18] Especially, the Camitz opponensplasty using the palmaris longus (PL) is the most commonly employed tendon transfer for severe CTS patients with distinct significant thenar muscle atrophy and loss of thumb opposition. [2][3][4][5][6][7][8][9][10][11][12]15 Currently, the Camitz opponensplasty combined with carpal tunnel release is a standard procedure using the PL transfer continued with a strip of palmar aponeurosis to the insertion of the APB. [2][3][4][5][6][7][8][9][10][11][12] Foucher et al reported that the Camitz opponensplasty combined with carpal tunnel release provided 90.7% good long-term results.…”

Section: Introductionmentioning

confidence: 99%

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Minimally invasive modified Camitz opponensplasty for severe carpal tunnel syndrome

Nanno

Kodera

Tomori

et al. 2018

J Orthop Surg (Hong Kong)

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Purpose: We aimed to compare the clinical results and the complications between the minimally invasive modified Camitz opponensplasty and the conventional Camitz opponensplasty for severe carpal tunnel syndrome (CTS), and to evaluate the efficacy of the modified technique for CTS. Methods: Twenty-eight hands in 24 patients with severe CTS who had disorder of the thumb opposition with thenar muscle atrophy (group 1) were treated by minimally invasive modified Camitz opponensplasty, passing the transferred palmaris longus (PL) tendon under the abductor pollicis brevis (APB) fascia using only palm and thumb incision, and no incision to either wrist crease or forearm. Ten hands in 10 patients (group 2) were treated by the conventional Camitz opponensplasty. Clinical evaluation was made by comparing the results before and after surgery for the angle of the thumb palmar abduction, pinch power, and grip strength. Results: All clinical findings significantly improved after surgery compared with before surgery in all patients. In group 1, there were no complications including transferred tendon bowstring, painful wrist scar, or injury to the palmar cutaneous branch of the median nerve in all hands. Conversely, patients in group 2 had four painful wrist scars and nine bowstrings of the transferred tendon. Conclusions: Several complications have been considered to attribute to the long incision and an extensive dissection crossing the wrist crease from the palm to the wrist in the conventional Camitz procedure. The current modified Camitz opponensplasty by minimally invasive incision without straddling the wrist crease is a simple and effective procedure that can decrease the risk of painful scar around the wrist crease in severe CTS patients with disorder of thumb opposition. Additionally, this technique, by passing the transferred PL tendon under the APB fascia, is useful in restoring the thumb opposition immediately, and in preventing the bowstringing of the transferred tendon.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Minimally invasive modified Camitz opponensplasty for severe carpal tunnel syndrome

Nanno

Kodera

Tomori

et al. 2018

J Orthop Surg (Hong Kong)

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show abstract

“…2) It is indicated for patients who have loss of thumb abduction and opposition secondary to thenar wasting from a low median nerve palsy. It mainly restores thumb palmar abduction and has the advantage being able to perform an open carpal tunnel release at the same time of the opponensplasty.…”

Section: Introductionmentioning

confidence: 99%

Thumb Function and Electromyography Result after Modified Camitz Tendon Transfer

Durban

Antolin

et al. 2017

J Hand Surg Asian-Pac Vol

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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.

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Motor Loss

Kim¹,

Yoo²

2019

The Thumb

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Modified Camitz Opponensplasty for Severe Thenar Wasting Secondary to Carpal Tunnel Syndrome: Case Series

Cited by 25 publications

References 7 publications

Minimally invasive modified Camitz opponensplasty for severe carpal tunnel syndrome

Minimally invasive modified Camitz opponensplasty for severe carpal tunnel syndrome

Thumb Function and Electromyography Result after Modified Camitz Tendon Transfer

Motor Loss

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