. Annals of surgery . ored, (Figs. 6—.\, H, C.) In Steindlers operation for the ])lastic substitution of the oppens actionof the thumb the sheath of the flexor longus pollicis is split and the tendondivided longitudinally, one-half of the tendon is inserted into the outer side ofthe base of the first and sutured to the periosteum. The sheath of theflexor longus pollicis is then closed. This half of the tendon is now running inthe direction of the paralysed oppens pollicis, and each flexor movement of the 836 TREATMENT OF DISABILITIES OF THE HAND thumb will l)e accompanied by an opposi
. Annals of surgery . ored, (Figs. 6—.\, H, C.) In Steindlers operation for the ])lastic substitution of the oppens actionof the thumb the sheath of the flexor longus pollicis is split and the tendondivided longitudinally, one-half of the tendon is inserted into the outer side ofthe base of the first and sutured to the periosteum. The sheath of theflexor longus pollicis is then closed. This half of the tendon is now running inthe direction of the paralysed oppens pollicis, and each flexor movement of the 836 TREATMENT OF DISABILITIES OF THE HAND thumb will l)e accompanied by an opposition movement of the thumb againstthe fingers. Neys operation is a tendon transplant for paralysis of the intrinsic musclesof the hand. The greatest disability of this condition is the loss of theopposing action of the thumb. To overcome it The short extensor tendon ofthe thumb is passed through a tunnel under the anterior annular ligament andtransplanted into the tendon of the jialmaris longus. or that muscle being. Fic. 6B.—Baldwins operation of arthrodesis of basal joint has been performed and thethumb placed in the position of Rrasp. absent (al)out 20 per cent, of cases), into the flexor carpi radialis without theflivision of this latters tendon. The Treatment of Stiff Metacarpal Joints.—Under this head we will takeuj) the cases in which there is no gross bony change, but where the flexion ofthe metacarpal joints have l>een interfered with by changes in the joint capsule,contracture of the extensor tendons, involvement of these tendons in the scar,or a combination of all three. This latter condition is quite common afterinfection. Stiffness of the metacar])o-i)halangeal joints is always a seriousdisability because without flexion at the metacarpo-i)halangeal joints a goodgrasp is impossible. The disability is said to be caused by improper our experience this is by no means the whole story, we have seen it occuras a sequel in cases of nerve injur} and i
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectsurgery, bookyear1885
