CARPECTOMY AND FUSION IN ADULT-ACQUIRED HAND SPASTICITY

Five adult patients with voluntary hand control, complicated by severe flexion contracture and spasticity secondary to brain injury, underwe nt subtotal carpectomy and radio-carpal or radio-metacarpal fusion. No ne of the patients were capable of functional prehension before surger y, and all had difficulty with hygiene due to their deformity, The def ormities were beyond the scope of correction with soft tissue release, Two of the patients had previously undergone flexor-pronator origin r elease, musculo-tendinous lengthening of the wrist and finger flexors, or a combination of both. All five patients progressed to union witho ut complication. Four achieved meaningful gains in functional grasp-re lease of the hand following the surgery.