FDS Oppositionplasty

This 2013 ink and watercolour image was produced for the British Society for Surgery of the Hand autumn meeting programme. It depicts an intermediate stage of a tendon transfer procedure.

These operations are common in hand surgery, being used to restore finger and wrist movement at joints where their original muscle has been paralysed. In this instance the Flexor Digitorum Superficialis tendon from the ring finger has been sacrificed, with no loss of function, and will be transferred under the palmar skin before attachment to the side of the thumb, as demonstrated. Note the second incision within the palm just under the thumb. This will restore the thumb’s ability to touch the little finger (or ulnar) side of the hand. A manoeuvre known as “opposition”, and which sets humans apart from other primates.

Donald has provided cover illustrations for numerous BAPRAS and British Society for Surgery of the Hand publications.