Surgery of the spastic thumb-in-palm deformity

A twenty-year experience with a surgical procedure, previously described, for dynamic correction of spastic thumb-in-palm deformity in cerebral palsy is reported. The procedure includes lengthening of the long flexor of the thumb, proximal thumb intrinsic release and augmentation of abduction-extension of the thumb. Bone-stabilising operations are not performed. 56 patients have been followed up for an average period of 4 years and 11 months after the treatment (range 2 to 15 years). Correction of the deformity is recorded in 82% of the patients.