Clawfinger correction: results of extensor-flexor many tailed operation

Area of Science:

• Hand surgery
• Reconstructive surgery
• Orthopedics

Background:

• Paralytic clawfingers significantly handicap patients, particularly those with leprosy reliant on hand function for income.
• Ulnar palsy leads to a critical loss of finger extension and the ability to 'reach out'.
• Restoring intrinsic hand function is crucial for improving quality of life.

Purpose of the Study:

• To assess the efficacy of using the extensor carpi radialis longus (ECRL) as a functional substitute for lost lumbrical-interosseus function.
• To evaluate surgical outcomes in patients with ulnar palsy affecting hand function.
• To identify factors influencing successful functional restoration.

Main Methods:

• A follow-up study involving 155 hands with paralytic clawfingers.
• Surgical reconstruction utilizing the extensor carpi radialis longus to replace intrinsic muscle function.
• Assessment of functional outcomes, focusing on finger extension and hand arch stability.

Main Results:

• The extensor carpi radialis longus effectively substituted for lumbrical-interosseus function in 155 hands.
• Optimal functional recovery was observed in hands achieving full assisted extension.
• Metacarpal arch retropulsion was a consistent finding in cases of total ulnar function loss.

Conclusions:

• Reconstruction with the extensor carpi radialis longus offers a viable solution for restoring hand function in ulnar palsy.
• Achieving full assisted extension is key to maximizing functional gains.
• Understanding the biomechanics of ulnar palsy is essential for surgical planning and patient outcomes.