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Correction of “ Thumb-in-Palm ” Deformity in an Adult Patient with Cerebral Palsy : A Different Indication and a Different Approach

Thumb-in-palm deformity in patients with cerebral palsy is functionally disabling because of lacking thumb motion. The major reasons for selecting surgical treatment are to effect improvement in the performance of thumb activities and to produce aesthetic appearance so that it no longer interferes with the function of the other digits. However, this deformity as itself in Turkish culture is so close to an abusive act which can be defined as shaking of the hand with the thumb hidden in palm or in the second web space. A 34 year old male patient, whose main complaint was the position of his thumb being misunderstood by other people as an abusive gesture, was consulted to our clinic. Web-space releasing, myotenotomy, and tendon transfer operations were performed simultaneously. The patient gained grasping function by maintaining his thumb out of his palm. Communicative skills were improved and better hand hygiene was acquired.