Opposition of the thumb is the most important component of normal hand function and its loss constitutes a significant disability. An opposable thumb is responsible for most of the power of pinch and grasp. Three patients were lost the ability of opposition -of thumb due to posttraumatic median nerve palsies and sequale of electric bum. They were treated by different methods of tendon transfer, the flexor digitorm sublimis was used in case 1, extensor indicis proprius in case 2, palmaris longus in cases 3.
In case, 1, The sublimis transfer from long finger was done. Reevaluation after 5 years revealed flexion Contracture of proximal interphal-angeal joint of long finger. Therefore careful intaoperative technique should be used, and this procedure should be limited only to absolutely indicated cases.
In case 3, palmaris longus opponensplasty was very simple and not disturbed normal hand function, but it was limited in high median nerve palsy and comcomit-ent palmaris longus injury.
As case 2, extensor indicis proprius opponensplasty has many advantages such as this motor unit is available in volar wrist injury and combined median and ulnar palsies, and require a single muscle tendon unit without a tendon graft.
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