[Critical evaluation of the results following corrective operations of the spastically paralyzed hand]

The objective of surgery on a spastically paralysed upper limb is the elimination of the contractures and the restoration of the muscular equilibrium. In this way, the entire hand function, but also the body posture can be improved. The operation is one link in the chain of treatment consisting of physiotherapy, occupational therapy and provision of splints. We report on the results of a follow-up examination of 45 patients in whom various surgical techniques were applied. The observation period ranges from two to 16 years. A marked improvement of function combined with subjective satisfaction could be attained in more than half of the patients. The result of surgery is mainly influenced by the joint contractures, and much less by the sensitivity or by the type of paralysis. The indication for and the principles of surgical treatment as well as the various possibilities for this are discussed. We consider that surgery is indicated in early childhood.