Treatment of spastic thumb-in-palm deformity: a modified extensor pollicis longus tendon rerouting

Fourteen patients (15 hands) with spastic thumb-in-palm deformities were treated with a modified technique of extensor pollicis longus tendon rerouting. Twelve patients obtained satisfactory correction of their deformities. Although functional improvement was not always anticipated, it was achieved to some degree in 12 patients. Extensor pollicis longus tendon rerouting can provide satisfactory correction of severe thumb-in-palm deformity especially when combined with other procedures such as metacarpophalangeal joint arthrodesis and thumb intrinsic muscle release. The modified rerouting technique can be done with a single incision and allows easy adjustment of tension.