- Discussion:
- hands of wrists in arthrogryposis are marked by weak muscles, stiff MP & IP joints, adducted thumb, and flexed and ulnar-deviated wrist;
- hand that has pinch and grasp is best left untreated;
- sublimis release>
- for flexion of proximal interphalangeal joint;
- predicatable success;
- fingers that are stiff in full extension may be improved by releasing joints & allowing the fingers to stiffen in flexion;
- adducted thumb:
- required web releases soin grafting, and tendon transfers to extenor/and abductors, most often using sublimis;
- wrist
- flexed wrist is commonly of benefit to allow bent fingers to hook objects;
- serial casting of flexed wrist should precede proposed arthrodesis to confirm functional improvement
Surgical correction of thumb deformity in arthrogryposis and multiplex congenita.