Adduction contracture thumb

Abstract

Adduction contracture of the thumb predominantly affects the movements at the trapeziometacarpal joint, rendering the thumb ineffective in opposition and thereby destroying the essential element of grasp and pinch. It is the dominant hand of a family bread earner which is most commonly involved and proper primary management can avoid contracture development. Adequate release of the contracted first web space from hinge to hinge followed by a local skin flap cover and dynamic abduction splintage for the subsequent six weeks can give excellent results. Documenting the first web angle at every follow-up can detect early recurrences and dynamic splintage can be reinstituted to revert it back to normal dimensions. Secondary surgery in the form of flexor pollicis longus tendon lengthening or opponens-plasty helps to prevent recurrence of the contracture.