Management of the unbalanced wrist in cerebral palsy by tendon transfer

Over a 25-year period, 60 children with spasticity of the upper extremity mainly resulting from cerebral palsy underwent surgical reconstruction of the unbalanced wrist. A detailed classification of the deformity is described on the basis of the functional anatomy of the unbalanced wrist in cerebral palsy, which was divided into three groups. In retrospective analysis of the long-term results, this classification has proved helpful in selecting an option for the treatment of this difficult deformity. In addition, the described classification has aided us in keeping accurate follow-up records in predicting the progress of the patient, and in coordinating the postoperative treatment.