Comparison of opponensplasty techniques in isolated low median nerve palsy

Abstract

Background: Thumb opposition is a critical operation of thumb. Median nerve palsy interferes with a large number of ordinary activities such as opposition. Opponensplasty for low median nerve injury is performed with various techniques. The purpose of this study is to compare tendon transfer techniques of Riordan and Burckhalter. Methods: This study was a clinical trial performed on 120 patients who underwent Opponensplasty. Patients with traumatic low nerve palsy were divided into two equal groups of Riordan and Burckhalter operation. Demographic information, functional status, Kapandji score, and Pulp pinching method were recorded and compared for all patients 3 months and 8 months after surgery. Findings: Performance status, Kapandji score and Pulp pinching tests showed significant improvements in both groups after surgeries. The changes in pressure between the thumb and fifth finger were significantly greater in the Burckhalter method compared with Riordan method (P<0.05). The incidence of complications was significantly higher in the Riordan group (P=0.01). Conclusion: According to the present study, there was no differences between Burckhalter and Riordan methods in terms of opposition recovery, although Burckhalter's opponensplasty had better therapeutic results. Postoperative complications were also less in the Burckhalter method.