Thumb Function and Electromyography Result after Modified Camitz Tendon Transfer

Abstract

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.

A new method of measuring the thumb pronation and palmar abduction angles during opposition movement using a three-axis gyroscope

“…We believe that measuring thumb pronation angle using a gyroscope has many advantages. Kapandji scores [ 44 ] are widely used to evaluate thumb opposition in clinical practice [ 20 , 45 – 52 ]. However, it is not an accurate quantitative evaluation method but only a numerical categorized method; moreover, there were reports that almost all healthy subject and even CTS patients with thenar atrophy were able to obtain 9 or 10 points of this score [ 22 , 53 ].…”

The Influence of the Tissue Adhesive Material as a Surgical Wound-Closure Technique Following Carpal Tunnel Decompression on Neurological and Functional Outcomes: A Single-Center Randomized Controlled Trial

“…The control group underwent standard surgical decompression, and the intervention group underwent surgical decompression with a single injection of platelet-rich plasma introduced through the mini-vacuum drain [31]. Similarly, modified Camitz opponensplasty did not correlate with neurologic and muscle recovery in a study of 21 participants with severe CTS [32]. A retrospective study that compared endoscopic carpal tunnel release with open carpal tunnel release did not find any differences in outcomes, including electromyographic abnormalities [33].…”

Neurostimulation in severe carpal tunnel release: A more precise technique for opponensplasty decision-making

“…Even in individuals with missing motor nerve function on preoperative nerve conduction testing, Park et al[ 29 ] found that thenar atrophy could improve concurrently with motor recovery after CTR alone. According to Durban et al[ 30 ] and Hattori et al,[ 31 ] more than one-third of patients with severe CTS and thenar atrophy showed electrophysiological recovery of APB during the postoperative period. In our study, in three hands in contractile group, thenar atrophy recovered, while non-stimulated group showed no recovery.…”