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Hand & Wrist in Arthrogryposis



- 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.