Published on 19/04/2015 by admin
Filed under Surgery
Last modified 19/04/2015
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Procedure 22 Intrinsic Muscle Release for Thumb-in-Palm Deformity
Harry A. Hoyen, Patrick J. Messerschmitt
See Video 19: Intrinsic Muscle Release for Thumb-in-Palm Deformity and Adductor Release Using a Thenar Incision
Spastic contracture of the thumb adductor muscle results in excessive thumb metacarpal adduction and thumb-in-palm deformity.
In mild or moderate degrees, grasp and pinch are affected when other intrinsic and extrinsic contractures result in compromise of skin care and hygiene.
This procedure is often combined with other surgical release procedures for the thumb, fingers, and wrist.
Examination of the hand demonstrates an adducted position of the thumb metacarpal across the palm of the hand (Figs. 22-1 and 22-2).
Additional deformities of the wrist and hand frequently can coexist with the thumb-in-palm deformity (Fig. 22-3).
Evaluate for flexion deformities of the thumb metacarpophalangeal joint and/or thumb interphalangeal joint, which would require concomitant releases of the flexor pollicis brevis or flexor pollicis longus, respectively.
FIGURE 22-1
FIGURE 22-2
FIGURE 22-3
Thenar muscles, flexor pollicis longus, adductor pollicis, lumbricals, and interosseous muscles
Recurrent motor branch of the medial nerve and the common digital nerves
Superficial and deep palmar arterial arches
Operative Techniques Hand and Wrist Surgery
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See Video 19: Intrinsic Muscle Release for Thumb-in-Palm Deformity and Adductor Release Using a Thenar Incision
