Cerebral Palsy-Redirection of extensor pollicis longus in the treatment of spastic thumb-in-palm deformity

Redirection of extensor pollicis longus in the treatment of spastic thumb-in-palm deformity

Pdf Summary

The document discusses a surgical procedure to treat thumb-in-palm deformity in patients with cerebral palsy. The procedure involves redirecting the extensor pollicis longus (EPL) tendon through the first dorsal retinacular compartment and releasing the spastic intrinsic thenar muscles. The redirected EPL tendon helps improve extension-abduction of the thumb, allowing patients to grasp with the thumb outside the clenched fist. The surgery is considered an ideal treatment for thumb-in-palm deformity because it relieves the adduction deforming force and augments weak extension-abduction. Postoperative reeducation of the transfer is minimal. The document provides surgical indications, procedures, and results of the procedure. The results were generally good, with all patients having an abducted-extended position of the thumb during digital extension and most patients experiencing improvement in functional activities. The document also discusses the selection criteria for the procedure, the importance of voluntary active function of the EPL muscle, and the potential contribution of tenodesis effect on the EPL tendon. Overall, the procedure has been successful in improving thumb position and function in patients with thumb-in-palm deformity.

Keywords

surgical procedure

thumb-in-palm deformity

cerebral palsy

extensor pollicis longus tendon

abduction

adduction deforming force

postoperative reeducation

functional activities

selection criteria

thumb function