Surgical correction of spastic thumb-in-palm deformity

Area of Science:

• Orthopedics
• Neurosurgery
• Rehabilitation Medicine

Background:

• Spastic thumb-in-palm deformity is a common challenge in patients with upper extremity spasticity.
• This complex disability often requires multifaceted surgical and therapeutic interventions.

Purpose of the Study:

• To report the outcomes of surgical correction for spastic thumb-in-palm deformity.
• To evaluate the necessity of supplementary procedures and motor function augmentation.

Main Methods:

• A retrospective review of 31 operations performed on 27 patients with spastic thumb-in-palm deformity.
• Surgical techniques and patient cases were presented, with follow-up periods of at least one year.

Main Results:

• Approximately 70% of operations involved supplementary procedures due to the complexity of spastic upper extremity disability.
• Recurrence occurred in two cases, highlighting the need for motor function augmentation.
• The majority of patients showed improvement, with the thumb no longer clenched in the palm and increased hand utility for gross grasping.

Conclusions:

• Surgical intervention can effectively improve function in spastic thumb-in-palm deformity.
• Augmentation of extensor-abductor motor function is essential for sustained correction and preventing recurrence.
• While functional improvement is significant, the spastic hand typically does not become the primary functioning hand post-operatively.