Correction of intrinsic-minus hands associated with reversal of the transverse metacarpal arch.

In a hand with paralysis of the intrinsic muscles, the clawing of the fingers is associated with deformity of the distal transverse metacarpal arch. The arch is often flattened in the open-hand position and is sometimes reversed. Sixteen hands were operated on with a new tendon-transfer procedure aimed at simultaneous correction of the deformities of the arch and of the fingers. Adequate restoration of the arch was attained in all sixteen hands while the deformity and disability were corrected in 85 per cent of the fingers.