Reconstructive hand surgery in tetraplegia, stroke, and cerebral palsy: some basic concepts in physiology and neurology.

The examination of hands in tetraplegia, stroke, and cerebral palsy must include evaluation of the state of the ligaments the muscles available for motors for tendon transfer, and, most important, the areas of sensibility. The test for two point discrimination is the most valuable in providing information regarding both exteroception and proprioception. Done properly, this test provides more useful information than any other used currently.