The Journal of Bone and Joint Surgery, Vol 69, Issue 8 1127-1132, Copyright © 1987 by Journal of Bone and Joint Surgery, Inc
Results of transfer of the flexor digitorum superficialis tendons to the flexor digitorum profundus tendons in adults with acquired spasticity of the hand
MA Keenan, JI Korchek, MJ Botte, CW Smith and DE Garland
Adult Head Trauma Service, Ranchos Los Amigos Medical Center, Downey, California 90242.
Thirty-one patients who had transfer of the flexor digitorum superficialis
tendons to the flexor digitorum profundus tendons en masse in thirty-four
non-functional spastic hands were examined at an average of fifty months
postoperatively. All of the patients had had a clenched-fist deformity
preoperatively, with severe hygienic problems of the palmar skin and no
active function of the hand. Postoperatively, all of the hands were in an
open position, which allowed for good hygiene of the palmar surface. A
minor wound infection developed in three patients. Neurectomy of the motor
branch of the ulnar nerve distal to the Guyon canal was needed for control
of spasticity of the intrinsic muscles in twenty-five hands. An
intrinsic-minus deformity did not develop in any of the hands that had
neurectomy of the ulnar nerve, although an intrinsic-plus deformity
developed in seven of the nine hands that did not have a neurectomy.