[Orthopedic surgery of the hand in patients with cerebral palsy (author's transl)].

During the last 15 years surgical interventions on the hands of 47 patients with cerebral palsy were performed. Most suffered from hemiplegia. Electromyographic analysis of arm- hand function showed 1. Decrease in maximal activity 2. Impulse irradiation preferably to flexor muscles 3. Associated activation of the affected contralateral limb 4. Identical patterns of activity in flexion or extension intentions 5. Occasionally reflex activity surmounts voluntary activity 6. Tendency towards tonic activation. By questionnaires the patients were asked to report their own impressions on the results of surgery as to function and appearance of the operated limb. In 30 replies 22 patients reported good results in appearance as well as in function and felt the procedure recommendable. Another 7 patients rated the result as fair, with partial improvement of appearance, without functional deterioration. The only patient who felt his condition worse suffered from epileptic disorder and related increase of spasticity with deterioration of gait to hand surgery, which, however, was without realistic grounds. It is concluded that corrective surgery in the hands of cerebral palsied patients may be fairly rewarding.