[Selective nerve transfers for thenar branch reconstruction].

[OPERATIVE] Reconstruction of thump opposition with selective nerve transfer of the motor branch of the abductor digiti minimi muscle (ADM) to the thenar motor branch.

[INDICATIONS] Injury of the median nerve or thenar motor branch and resulting loss of thumb opposition.

[CONTRAINDICATIONS] Combined median and ulnar nerve injuries or brachial plexus lesions of C8-Th1, or a time interval >12 months since denervation of the thenar branch.

[SURGICAL TECHNIQUE] The ADM motor branch is microsurgically dissected and transferred to the thenar branch.

[POSTOPERATIVE MANAGEMENT] After successful reinnervation, regular follow-ups and intensive physiotherapy are important for operative outcome.

[RESULTS] Reconstruction of the opposition of the thumb results in improved range of motion as well as a gain of grip and pinch force.