A treatise on orthopedic surgery . omplete re-covery is unusual. In slighter cases of radial club-hand, due to defective develop-ment, it may be possible by manip-ulation and tenotomy to replacethe hand in its normal position,but this is unusual. After divisionof the contracted tissues, Sayre^removed a portion of the carpusand implanted the head of theulna at the point of ^ sawed through theulna, leaving the extremity in re-lation to the carpus and suturedthe proximal fragment and thesemilunar bone to one ^ replaced the hand bysubcutaneous tenotomy and by the re
A treatise on orthopedic surgery . omplete re-covery is unusual. In slighter cases of radial club-hand, due to defective develop-ment, it may be possible by manip-ulation and tenotomy to replacethe hand in its normal position,but this is unusual. After divisionof the contracted tissues, Sayre^removed a portion of the carpusand implanted the head of theulna at the point of ^ sawed through theulna, leaving the extremity in re-lation to the carpus and suturedthe proximal fragment and thesemilunar bone to one ^ replaced the hand bysubcutaneous tenotomy and by the removal of a cuneiformsection of bone from the lower end of the ulna. The operation of splitting the ulna into an ulnar and radialportion and implanting the carpus between the two has beenjDerformed by Bardenheuer.* The immediate effect of the ^ Transactions American Orthopedic Association, vol. vi.^ Ibid., vol. viii. ^ Transactions American Orthopedic Association, vol. ix. Verhand. der deutsch. Gesells. f. Chir., 23 Kong., 1894. 33. congenital club-hands, showingthe short and deformed forearms,also bow-legs. (Gibney.) 514 OBTHOPEDIC SUEGEBY. various operative procedures was favorable, but no final resultshave been reported. In any event some form of apparatus must be used duringchildhood at least, to support the hand, whether the operationhas been successful or not. It is therefore better to defer radicaltreatment; at best the arm will be short and the defective handwill be weak as compared with the normal, CONTRACTIONS AND DISTORTIONS OF THE FINGERS. Congenital Contraction of the Fingers.—The most commonform of congenital contraction and one that is sometimes hered-itary is that of the little finger (hammer finger) of one or bothhands. This is semiflexed and extension is checked by whatappears to be a congenital shortening of all the soft parts on theflexor side. In other instances several fingers may be similarlyaffected. Treatment.—If treatment by manipulation and splinti
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