What Function Does the Patient Need? (Table 5)
It is important that a donor muscle tendon unit selected for transfer is both functioning and expendable. There is some variation in patterns of muscle paralysis, so a specific physical exam and possible electromyography may be necessary to determine whether a potential donor muscle is intact, innervated, and contractile. Particularly when treating patients with progressive neurological disorders, such as Charcot-Marie-Tooth, the surgeon must establish whether a contractile muscle will remain functioning. In this disorder, intrinsic muscles of the hand are most commonly paralyzed. Thus, an abductor digiti minimi (ADM) opponensplasty would be ill advised and an FDS opponensplasty would be preferred.