A double synergistic approach to correction of the intrinsic minus hand

In the search of a method for the correction of the intrinsic minus hand with simplified post-operative physiotherapy training, preferably dynamic methods acting in a synergistic way, two methods were identified, one correcting clawing in extension, the other correcting clawing in flexion under strain. Forty-three patients (53 hands) were operated upon using a combination of the methods. The immediate post-operative results showed that 50 of the hands had satisfactory result. Twenty patients (26 hands) were traced and reviewed after 0.5-5.5 years (average 2.75 years) and 14 of these hands showed good, 11 fair, and one poor result. All patients reported that their hand function had improved after correction. Post-operatively, the physiotherapy staff were only required to exercise active extension and flexion of the fingers. The advantages and disadvantages of the approach are discussed. The method requires an experienced surgeon but the post-operative training is simple and there is no need for re-education of transferred tendons. I have found the method useful for patients with difficulties in re-education and for patients in programmes where the physiotherapy back up is less developed.