[Surgical possibilities in XXXX of arm and hand].

@entity1 @entity1516 @entity508 @entity260 @entity912 @entity306
OBJECTIVE: To determine the results of surgical correction of @entity912 of the hand due to @entity306 . DESIGN: Descriptive. SETTING: Academic Medical Centre, Amsterdam, the Netherlands, and rehabilitation centre De Trappenberg. METHOD: From 1-1-1990 until 1-6-1994 twenty @entity1 with @entity508 upper limb in @entity306 were operated in our hospital. They were all seen preoperatively by our multidisciplinary team, and selected according to the Zancolli classification. Seventeen operations were aimed at improving hand function, the other three were performed for contractures or for cosmetic/hygienic reasons. Surgery was aimed at correcting the muscular imbalance, by weakening @entity508 muscles via tenotomy or lengthening and by reinforcing paralysed muscles via tendon transfer or rerouting. Often stabilisation of joints by tenodesis, capsulodesis or arthrodesis was necessary as well. RESULTS: Eighteen of the twenty @entity1 were (very) happy with the results. In two @entity1 there was no functional gain. Only once was a @entity260 seen: @entity1516 of the first carpometacarpal joint. This was corrected successfully by rearthrodesis. We found we were able to predict the functional outcome fairly accurately. CONCLUSION: With accurate @entity1 selection, surgical intervention in @entity1 with @entity306 may restore hand function adequately and predictably.
