Immediate Thumb Extension following Extensor Indicis Proprius???to???Extensor Pollicis Longus Tendon Transfer Using the Wide-Awake Approach

Abstract

The wide-awake approach has allowed the authors to adjust tendon transfer tension with active movement before skin closure without the risks associated with general or regional anesthesia. In addition, it has allowed them to observe immediate cortical adaptation in the context of a simple tendon transfer. The authors hypothesize that the brain's ability to immediately use extensor indicis proprius for thumb extension stems from the activation of preexisting synergistic cortical finger movement programs.