HAND FUNCTION IN CHILDREN WITH CEREBRAL-PALSY AFTER UPPER-LIMB TENDONTRANSFER AND MUSCLE RELEASE

Thirty-two children with hand dysfunction due to cerebral palsy were e xamined before tendon transfer and muscle release, and 9 months postop eratively. All children improved their performance regardless of the d egree of impaired hand function. The main advantage of surgery was a m ore functional position of the hand with increased wrist extension and forearm supination. There were also increased functionality of handgr ips, grip strength, and dexterity. Impaired sensibility before surgery did not influence the outcome. Individual goals were set preoperative ly. Individual functional goals outlined before surgery were met by mo st children. Children identified as having mild impairments gained new functional skills related to everyday activity (self-care and leisure ), while children with severely impaired hand function demonstrated en hanced grasping ability, as well as a better cosmetic appearance.