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 Indications 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/Imaging Clinical Examination 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 Surgical Anatomy 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 Positioning The patient is positioned supine with the arm extended onto a surgical arm board. Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related Related posts: 35: Silicone Metacarpophalangeal Joint Arthroplasty 85: Wrist Denervation 38: Reconstruction for Congenital Thumb Hypoplasia 65: Arthroscopic Treatment for Septic Arthritis 64: Diagnostic Wrist Arthroscopy 89: Total Wrist Fusion Stay updated, free articles. Join our Telegram channel Join Tags: Operative Techniques Hand and Wrist Surgery Mar 5, 2016 | Posted by admin in Hand surgery | Comments Off on 22: Intrinsic Muscle Release for Thumb-in-Palm Deformity Full access? Get Clinical Tree
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 Indications 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/Imaging Clinical Examination 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 Surgical Anatomy 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 Positioning The patient is positioned supine with the arm extended onto a surgical arm board. Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related Related posts: 35: Silicone Metacarpophalangeal Joint Arthroplasty 85: Wrist Denervation 38: Reconstruction for Congenital Thumb Hypoplasia 65: Arthroscopic Treatment for Septic Arthritis 64: Diagnostic Wrist Arthroscopy 89: Total Wrist Fusion Stay updated, free articles. Join our Telegram channel Join Tags: Operative Techniques Hand and Wrist Surgery Mar 5, 2016 | Posted by admin in Hand surgery | Comments Off on 22: Intrinsic Muscle Release for Thumb-in-Palm Deformity Full access? Get Clinical Tree
See Video 19: Intrinsic Muscle Release for Thumb-in-Palm Deformity and Adductor Release Using a Thenar Incision
