Research Article| Volume 1, ISSUE 3, P197-204, December 1976

Proximal row carpectomy with muscle transfers for spastic paralysis

  • George E. Omer
    Reprint requests: George E. Omer, M.D., Department of Orthopaedics, University of New Mexico, Health Sciences Center, Albuquerque, N. M. 87131.
    From the Division of Hand Surgery, The University of New Mexico, Albuquerque

    Affiliated Hospitals, including The Carrie Tingley Hospital for Crippled Children, Truth or Consequences, N. M.
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  • David A. Capen
    From the Division of Hand Surgery, The University of New Mexico, Albuquerque

    Affiliated Hospitals, including The Carrie Tingley Hospital for Crippled Children, Truth or Consequences, N. M.
    Search for articles by this author
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      Fourteen patients with spastic paralysis from various causes (eight with cerebral palsy) who needed minimal two handed activities to assist in self-care and who desired improvement in appearance were treated by proximal row carpectomy. In twelve transfer of flexor carpi ulnaris to extensor carpi radialis brevis was done, and in two the extensors of the wrist were shortened. Various other procedures were done in some patients. Prolonged splinting was carried out. Better extension of the wrist was obtained and supination improved more when the transfer was subcutaneous around the ulnar border than when through the interosseus membrane. Less tendency for the carpus to displace ulnarward was seen when the distal half of the scaphoid was not removed. Strength of grasp and pinch improved, but ability to release objects was diminished due to the more dorsiflexed position of the wrist. Subjective use for two handed activities was improved and the patients were satisfied with the appearance.
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