01849nas a2200241   4500000000100000008004100001260001700042653001500059653001000074653001100084653001200095653001600107653002100123653001400144653001000158100001200168245012800180300000800308490000700316050001400323520125600337022001401593       2005                            d  c2005 Jan-Mar10aAdolescent10aAdult10aHumans10aleprosy10aMiddle Aged10aMuscle, Skeletal10aParalysis10aThumb1 aBeine A00aAbductor pollicis longus deviation graft operation: modified for stabilizing CMC and MCP joints of 'intrinsic minus' thumb.  a1-80 v77  aBEINE20053 a<p>The original procedure abductor pollicis longus deviation graft operation by Beine (1996) was introduced to correct retroposition of the thumb and to balance the instability at the carpometacarpal (CMC) joint in cases of ulnar-cum-low median palsy in leprosy, so that bone-using procedures can be avoided to some extent. It provides an antagonistic force to the action of the abductor pollicis longus (abd. pol. long.) by giving this muscle a second insertion, with the result that the action of the abd. pol. long. now stabilises to a considerable extent the CMC joint in its mid-rotational position by a partial replacement of the action of the opponens pollicis (opp. pol.) and abductor pollicis brevis (abd. pol. brev.). Experience over five years with the original procedure showed us that it can make an ulnar deviation more visible at the MCP joint of the thumb. The modification of the procedure corrects this as well, as the results in 12 hands of 11 patients have shown. Interestingly, of the 11 patients who underwent operation, one was not a leprosy patient, but referred to us for partial triple palsy of the left hand and arm without sensory loss. It is shown that the indication of this procedure is wider than mentioned earlier.</p>  a0254-9395