M. Erol DEMİRSEREN, İzzet KORKMAZ, Candemir CERAN, Kasim KİLİCARSLAN

Correction of thumb-in-palm deformity in an adult patient with cerebral palsy: A different indication and a different approach

Thumb-in-palm deformitesi olan serebral palsili hastalarda, baş parmak hareketlerindeki kayıp nedeniylefonksiyonel bir eksiklik söz konusudur. Cerrahi tedavideki en önemli amaçlar baş parmağın estetikgörünümü ve fonksiyonunun daha iyi bir hale getirilerek diğer parmakların hareketlerine engel teşkiletmemesidir. Bununla beraber baş parmağın avuç içindeki veya ikinci parmak aralığındaki fikse pozisyonu,Türk toplumunda kültürel olarak küfür veya hakaret anlamına da gelebilmektedir. Otuzdört yaşındaki birerkek hasta kliniğimize baş parmağının avuç içindeki pozisyonunun diğer insanlar tarafından yanlışanlaşılma şikayeti ile başvurdu. Hastaya aynı seansta birinci parmak aralığı serbestleştirilmesi,miyonörotomi ve tendon transferi işlemi yapıldı. Böylece toplum içindeki iletişimi ve el hijyeni daha iyi birhale geldi.

Serebral palsili yetişkin bir hastada thumb-in-palm deformitesinin düzeltilmesi: Farklı bir endikasyon ve farklı bir yaklaşım

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

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