Extensor indicis proprius opponensplasty - the burkhalter revisited.

The Extensor Indicis Proprius Opponensplasty although not widely exercised by hand surgeons has previously been shown to produce good results in the restoration of thumb opposition. Over the last 5 years the Extensor Indicis Proprius was selectively used in cases where the Flexor Digitorum Superficialis was unavailable or inappropriate. In a small case series operating on a total of six male patients with an average age of 32 and follow up of 12 months we have been impressed by the functional outcome and lack of donor site morbidity. The Extensor Indicis Proprius is expendable with minimal donor site morbidity, is of sufficient length and has an optimal line of pull to provide a superior mechanical advantage and a favourable torque when compared to Flexor Digitorum Superficialis.