Palmaris longus transfer for replacement of the first dorsal interosseous.

Using palmaris longus, the first dorsal interosseous was reconstructed without free tendon graft. Palmaris longus prolonged with a strip of palmar fascia was transferred rectilinearly to the site of insertion of the first dorsal interosseous via a subcutaneous tunnel and fixed. This method was applied to seven hands of six patients and the follow-up observation continued for more than six months postoperatively. In six hands, favourable stability and abduction function of the index finger was achieved. In one hand, adhesion occurred at the site of the first dorsal interosseous muscle resulting in tenodesis. This operative method appears to be useful in the reconstruction of the first dorsal interosseous muscle from non-recovering paralysis following injury of the first dorsal interosseous muscle, or ulnar nerve. This method may also be utilized after decompression of chronic compression of the ulnar nerve giving no expectation of complete recovery by the reconstruction and augmentation of the first dorsal interosseous muscle. No unpleasant side effect was encountered.