Treatment of congenital clasped thumb includes two types of therapy: conservative and surgical.

The evidence for surgical therapy is poor and it is thus only recommended if medical treatment is not effective.

In cases when all conservative treatment fails, surgical therapy may be necessary.

Surgery: Patients that do not respond well to medication or botulinum toxin injection are candidates for surgical therapy.

"Within the past year, it has progressed to the degree that surgical therapy is now necessary," he said.

When people are not benefiting from medication, the guidelines call for doctors to consider surgical therapy as an option.

In some advanced cases that don't respond to medical or surgical therapy, slaughter should be considered from an economic perspective.

Certainly the doctors I spoke to there did not think lawsuit fears affect their decisions for surgical therapies and other such interventions.

The alternative means of treatment consists of surgical therapy.

Do you always use medical therapy before surgical therapy?