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The spastic thumb. Current concepts.

Isidro Jiménez1, Jonathan Caballero1, Pascal Jehanno2

  • 1Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain; Hospital Universitario San Roque Las Palmas, Las Palmas de Gran Canaria, Spain.

Hand Surgery & Rehabilitation
|July 1, 2026
PubMed
Summary
This summary is machine-generated.

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Surgical correction of the spastic thumb-in-palm deformity significantly improves hand function and aesthetics. Treatment strategies are individualized, yielding high patient and caregiver satisfaction.

Area of Science:

  • Orthopedic Surgery
  • Hand Surgery
  • Pediatric Orthopedics

Background:

  • The thumb-in-palm deformity, characterized by the thumb positioned within the palm, severely impairs hand function and hygiene.
  • This condition typically arises from intrinsic muscle spasticity and weakened thumb retropulsion/extension, potentially involving the flexor pollicis longus.

Purpose of the Study:

  • To outline surgical strategies for correcting the spastic thumb-in-palm deformity.
  • To emphasize the importance of individualized treatment plans for functional and aesthetic hand improvement.

Main Methods:

  • Surgical interventions are tailored based on thorough physical examination and patient-specific goals.
  • Options include muscle release/lengthening, tendon transfers for extensor/abductor augmentation, joint procedures, and neurectomies.
Keywords:
Cerebral palsyHandSpasticityThumb-in-palmUpper motor neuron syndrome.

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Main Results:

  • Most patients experience significant functional and aesthetic improvements following surgical correction.
  • High levels of satisfaction are reported by both patients and caregivers post-treatment.

Conclusions:

  • Surgical correction effectively addresses the thumb-in-palm deformity, enhancing overall hand function.
  • Achieving optimal outcomes requires meticulous surgical planning and execution due to the complexity of the condition.