Palmaris Longus Opponensplasty

The Camitz transfer and its modifications: a review

“…MacDougal et al (1995), Matsumura et al (1999) and Kato et al (2014) have all produced studies on the efficacy of passing the PL tendon through a pulley placed on the radial aspect of the released flexor retinaculum. This also makes the pull of the transferred PL tendon in line with the fibres of APB.…”

Flexor Superficialis Abductor Transfer With Carpal Tunnel Release for Thenar Palsy

“…Lin and Wei 29 discussed using various donor tendons to replace the function of paralyzed thenar muscles and noted that the palmaris longus has less capability of rotation and pronation when compared with the ring finger FDS-2 motions critical to the restoration of thumb opposition and one reason for past criticism of the Camitz 20 abductor transfer. 26,27 In a study of 73 cases in which the palmaris longus transfer was used as an opposition transfer in CTR Foucher et al 12 also saw no notable pronation when using the technique described by Littler and Li 9 and Camitz. 20 Opposition transfer and abductor transfer, however, are different in rationale, surgical method, and patient selection.…”

“…This is especially true in patients such as the elderly, in whom thenar palsy often is accompanied by degeneration of the trapeziometacarpal joint, further limiting active thumb pronation necessary for opposition. 26,27 The purpose of this study was to analyze retrospectively the results of CTR with simultaneous FDS abductor transfer for patients with thenar palsy secondary to profound CTS. For this population prolonged median neuropathy results in thenar atrophy and loss or marked limitation of the ability to abduct and ultimately to oppose the thumb.…”

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

“…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 ).…”