title: Surgical management of spastic thumb-in-palm deformity in adults with brain injury.
abstract: Spastic thumb-in-palm deformity was surgically treated in 27 adults with brain injury. Procedures included muscle lengthening, recession, or release, arthrodesis of the thumb interphalangeal joint, or Z-plasty of the thumb web space. At mean follow-up of 39 months, 23 of 27 had a satisfactory correction. Unsatisfactory results included two with inadequate correction and two with over-correction. Surgical treatment of this entity requires careful preoperative planning, addressing predominantly those spastic muscles responsible for the deformity.
authors.affiliation: Head Trauma Service, Rancho Los Amigos Medical Center, Downey, Calif.
authors.forename: M J
authors.initials: MJ
authors.lastname: Botte
authors.forename: M A
authors.initials: MA
authors.lastname: Keenan
authors.forename: H
authors.initials: H
authors.lastname: Gellman
authors.forename: D E
authors.initials: DE
authors.lastname: Garland
authors.forename: R L
authors.initials: RL
authors.lastname: Waters
mesh_terms: D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000150:complications*; D005260:Female; D006227:Hand Deformities, Acquired / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D009128:Muscle Spasticity / Q000209:etiology / Q000601:surgery*; D013933:Thumb / Q000473:pathology / Q000601:surgery*