Cerebral Palsy-Surgical Technique for Thumb-in-palm Deformity in Cerebral Palsy

Surgical Technique for Thumb-in-palm Deformity in Cerebral Palsy

Pdf Summary

The surgical technique for thumb-in-palm deformity in cerebral palsy involves releasing the adductor pollicis muscle to decrease the forces causing the deformity. Additional release of the thenar muscles or flexor pollicis longus may be done to further decrease the forces across the first ray. Tendon transfers, such as rerouting of the extensor pollicis longus, may also be performed to help avoid recurrence. Stabilization of the metacarpophalangeal joint may be necessary if there is hyperextension deformity. The assessment of the patient should occur over several visits to determine the best combination of procedures for functional improvement. With appropriate planning, meticulous surgical technique, and postoperative rehabilitation, patients can see significant improvement with surgical repositioning of the thumb. The article describes the types of thumb-in-palm deformity in cerebral palsy, indications for surgical management, contraindications, surgical anatomy, and potential complications. The surgical technique involves releasing the adductor pollicis muscle through a volar incision and rerouting the extensor pollicis longus through a dorsal incision. Postoperative immobilization with casting and splinting is necessary, followed by rehabilitation and active range of motion exercises. Thumb-in-palm reconstruction is a complex procedure that requires careful planning and assessment of the patient's condition. The goal of the surgery is to improve hand function and hygiene in patients with cerebral palsy and thumb-in-palm deformities.

Keywords

thumb-in-palm deformity

surgical technique

cerebral palsy

adductor pollicis muscle

forces

deformity

thenar muscles

flexor pollicis longus

tendon transfers

metacarpophalangeal joint