Anatomical And Clinical Study On Partial Pectoralis Minor Muscle Transplantation For Functional Reconstruction Of Opposition Of The Thumb

Objective: To explore and research one new method of opponensplasty by operation of using pectoralis minor muscle for its partial transplantation to reconstruct function of opposition of the thumb anastomosed vessels and nerves for better effection of opposition than that of former operations.Method: The blood supply and nerve innervation of pectoralis minor muscle and the comparison of the morphology and dimension of both pectoralis minor muscle and thenar muscle were investigated on 20 sides of adult cadaveric thoraxes and hands to evaluate the feasibility of new method. Undertake the preliminary test of reconstruct opposition function of the thumb by partial transplantation of pectoralis minor muscle and observe the effection of opposition of the thumb when pulling the fixed partial pectoralis minor muscle. Then selected 3 suitable cases with opposition function all lost and applied the new operation on them with partial transplantation of pectoralis minor muscle anatomosed vessels and nerves according to the results of anatomic study followed with functional recovery observation of opposition of the thumb. Results: â‘ The anatomical position of pectoralis minor muscles was constant and every pectorelis minor muscle was provided with self-sustaining artory, vein and nerve. The opposition process of cadaveric hand succeeded after similar transplantation to clinic operation. â‘¡]In clinical study the 3 cases recovered fully according to the standard of Cinese Hand-Surgery Association 6 month later postoperatively.Muscle strength of all 3 cases attached 5 class normally and a good manual ability recovered. The shape of thenar eminence was satisfactory and there was no adverse effect appeared on donor site of pectoralis minor muscle. Conclusions: Selecting part of pectoralis minor muscle for transplantation to thenar of hand to reconstruct opposition of the thumb anatomosed vessels and nerves is possible.It can achieve better result than that of former operation choices.