Surgical management of the thumb in cerebral palsy.

Surgical treatment of the thumb in cerebral palsy is complex and treatment must be directed toward the specific deformities. Thumb-in-palm deformity can be treated successfully in patients with spastic CP, but caution is required in patients with other varieties of CP. The main deforming force is contracture and spasticity of the intrinsic thumb muscles. Treatment involves release of the deforming muscles and other soft tissue, augmentation of opposing muscles, and stabilization of appropriate joints.