الفهرس 
Mechanics of oppositionOnly 14 pages are availabe for public view
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Abstract
Thumb opposition is a critical operation of thumb. Median nerve palsy interferes with a large number of ordinary activities such as opposition.
There are many potential causes of median nerve palsy, and thus a lack of opposition. These include acute median nerve laceration or damage from trauma as well as chronic median nerve compression from carpal tunnel syndrome, pronator syndrome, or cervical radiculopathy.
Opponensplasty for low median nerve injury is performed with various techniques. It is a commonly used tendon transfer to restore thumb opposition. The flexor digitorum superficialis (FDS) of the ring finger is the most commonly used donor motor unit in cases of low median nerve palsy.
Thirty patients treated with FDS Opponensplasty the patient’s ages ranged from 18-40 years, Assessment of opposition by Kapandji score and assessment of degree of pain by VAS and hand grip by QuickDASH score. All the patients will have nerve conduction and electromyogram, Clinically examination after 2 weeks and removal of the skin suture then at 4 weeks removal of the slab and allow for controlled range of motion, and at 3, 4 months postoperatively .
Kapandji score used to measure opposition of the thumb. There was an overall significant difference between Kapandji score before surgery, after 3 months, and after 6 months, P value was <0.001. Post-hoc analysis revealed that median Kapandji score was significantly lower before surgery (1) than after 3 months (5) and after 6 months (6). No significant difference was noted regarding Kapandji score between 3 months and 6 months.
The visual analog scale (VAS) used as a pain rating scale. There were no significant differences between VAS score before surgery, after 3 months, and after 6 months. P value was 0.5.
There was an overall significant difference between QuickDash score before surgery, after 3 months, and after 6 months, P value was <0.001. Post hoc analysis revealed that mean QuickDash score was significantly higher before surgery (24.7) than after 3 months (16.3) and after 6 months (14). Also, QuickDash score at 3 months was significantly higher (16.3) than after 6 months (14).
We found that FDS opponensplasty give better results in low median nerve palsy. The volar oblique incision offers clear visualization when detaching the FDS tendon, reducing the incidence of flexion deformity of the ring finger.