Immediate Post-operative Active Mobilization Following Opponensplasty

Objective: The purpose of this study is to compare the results of Immediate Post-operative Active Mobilization (IPAM) for

opponensplasty with post-operative immobilization.

Methodology: In a prospective study, 5 cases of pure lower median nerve and 10 cases of ulnar-median nerve paralysis had

opposition tendon transfer with FDSR followed by IPAM from 48 hours after surgery. Primary outcomes are ‘active abduction’,

‘pinch pattern’, ‘pinch strength’. The results of IPAM were compared with a retrospective cohort of similar transfer operated

prior to the IPAM trial and immobilized in a cast for 3 weeks. Statistical analysis was done by student t test.

Results: There were no incidences of tendon pullout during IPAM for opponensplasty. There were no differences in outcome

between the 2 groups at late follow-up evaluations, with all opposition transfers achieving good results.

Conclusion: The concept of applying IPAM for opponens tendon transfer is feasible, safe and without much discomfort to the

patient. Application of this technique with proper precaution reduces morbidity period by 19 days and enables earlier return

of function.