[Paralysis of the intrinsic muscles of the hand]

Palliative treatment of intrinsic muscle paralysis aims at correcting the claw deformity and improving prehension. This treatment will vary according to whether the claw can be actively corrected or not, if M. P. hyperextension is blocked. In the first category it suffices to maintain M. P. joint flexion either by capsulodesis or tenodesis so that the long extensors can extend the interphalangeal joints. Tendon transfers are useful only to reinforce the flexion force of the fingers if there is an associated long flexor tendon paralysis. These transfers should be fixed to the proximal part of the proximal phalanx. If the claw is not actively correctable, associated cutaneous, tendinous or joint lesions must co-exist and these will demand priority treatment. Tendon transfers, if possible, aim to extend the distal phalanges and should be fixed distally on the extensor expansion, knowing however that this carries the risk of swan neck deformity.