Wednesday, March 17, 2010

Hand Surgery:Flexor Pollicis Brevis

The flexor pollicis brevis is an intrinsic muscle of the hand that originates from the flexor retinaculum of the wrist and tubercle of the trapezium. The muscle inserts on the radial side at the base of the proximal phalanx of the thumb. The recurrent branch of the median nerve and the deep branch of the ulnar nerve provide motor innervation that allows the flexor pollicis brevis to flex the thumb at the first metacarpophalangeal joint.

Laceration of the flexor pollicis brevis due to trauma significantly impairs hand function as the patient is unable to fully oppose the thumb to the small finger.

I prefer repairing the tendon of the flexor pollicis brevis tendon with 3.0 and 4.0 nylon suture with a modified Kessler stitch and horizontal mattress sutures. A 5.0 epitendinous suture allows an adequate contour to the repair and facilitates opposition of the thumb to the small finger.


Brian P. Dickinson, M.D.