Residuals of a single-nerve injury, manifested by paralysis and muscle imbalance, are readily compensated for by appropriate tendon transfers. The procedure becomes complicated when any two nerves are involved. Correct evaluation of the partially paralyzed hand must be made and available tendon power must be concentrated where it will be effective in restoring useful function. Proper arthrodeses will provide stabilization and make additional power available for transfer. Not infrequently it is necessary to fuse the wrist or the thumb, or both, in a position of function, and to transfer wrist-extensor tendons, if a good pinch and grasping mechanism is to be gained. In badly crippled hands only a pinch mechanism may be possible, but to that end we should concentrate our effort; if we attempt more, potential power may he dissipated and a useless hand will result.
Copyright 1949 by The Journal of Bone and Joint Surgery, Incorporated