Surgical correction of thumb deformity in arthrogryposis multiplex congenita.

Four patients underwent surgical correction of five thumb deformities due to arthrogryposis. Although varying degrees of deformity were present, all exhibited adduction contracture, laxity of the ulnar collateral ligament at the metacarpophalangeal joint and absence of the abductor pollicis brevis. Techniques for release of the adduction contracture included Z-plasties or a local flap. Four thumbs had simultaneous opponensplasties performed and repair of the ulnar collateral ligament of the metacarpophalangeal joint. The patients have now been followed for an average of twenty-eight months (range 1 1/2 to 3 years). Parents and patients have been pleased with the results.