ObjectiveTo investigate the effectiveness of T1 rhizotomy combined with flexor origin slide for central hand flexion spasticity. Methods Between July 2023 and June 2025, 10 patients with central spastic flexion deformity and concomitant flexor tendon contracture due to traumatic brain injury, cerebral palsy, or other causes were admitted. All patients were treated with T1 rhizotomy combined with flexor origin slide. Postoperative assessments included the Modified Ashworth Scale (MAS) for muscle tone, Medical Research Council (MRC) scale for muscle strength, Fugl-Meyer score for upper extremity motor function, and House Functional Classification (HFC) for hand function. Results All patients successfully completed the operations and were followed up 6-19 months (median, 13 months). During follow-up, patients showed significant relief of hand spasticity and improvement in hand function. At last follow-up, the MAS grade for muscle tone, Fugl-Meyer score for upper extremity motor function, and HFC grade for hand function showed significant improvement compared to preoperative levels (P<0.05); but there was no significant difference in MRC grade for muscle strength or PRWE score between pre- and post-operation (P>0.05). Conclusion T1 rhizotomy combined with flexor origin slide effectively reduces muscle tone, corrects flexion deformity, and improves hand function, representing an effective surgical strategy for central spastic flexion deformity of the hand.