1. Improvement in the function of the hand crippled by arthritis is possible, no matter how severe the disability. [SEE FIG. 5-A, 5-B IN SOURCE PDF.
2. Prevention of deformity in chronic arthritis is much easier and gives a better end result than correction of deformity after the arthritis becomes quiescent. Deformity can be prevented by careful supervision and frequent splinting.
3. It is helpful to divide the treatment for rehabilitation of the hand into three stages. In the first stage, when deformity can be corrected passively, splints, exercises, and heat will usually correct the deformity. The measures are carried out simultaneously with the treatment of the patient for the chronic arthritis.
In the second stage, when deformity cannot be corrected passively and definite bony ankylosis is not present, more active measures, such as manipulations and constant traction should be added.
The third stage of operative correction of deformity should be undertaken in cases of quiescent arthritis only. Surgical procedures should be performed on the hand only after an appraisal of the functional status of the whole arm and with due regard to the functional need of the individual patient.
(C) 1935 All Rights Reserved.The Journal of Bone and Joint Surgery, Inc.