Reconstructive Surgery of Hands with Injured Central Metacarpophalangeal Joints

¹ Department of Surgery, University of North Carolina, Chapel Hill

1. The early treatment of injuries in the center of the hand should be directed toward the preservation of motion in the metacarpophalangeal joints.

2. Repair of the tendons and nerves and occasionally even of the bone should be delayed until the wounds in the damaged joints have healed and until motion has been restored.

3. Amputation should never be performed until it is certain that no further use may be made of the good parts of the finger which is to be deleted.

4. Single joint injuries can be treated by capsulotomy, fusion, or amputation combined with metacarpal transfer or recession of the digit into the palm.

5. A hand with a double joint injury may sometimes be reconstructed by combining the good parts of two worthless fingers into a single useful digit.

6. Multiple tendon transfers and joint arthrodesis may be performed to restore effective pinch to a hand in which the motor branch of the ulnar nerve has been disrupted.

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