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Surgery for the hand in cereberal plasy and after brain injury. (Spastic Hands)

Cerebral Palsy is a musculoskeletal deformity caused by brain injury that occurs around child birth.  The injury is irreversible but not progressive.  The extent of involvement of muscle control, sensation to the fingers and intelligence is variable. The hand is often involved with poor control of the muscles, deformities with reduced function.

The initial treatment protocol is hand therapy.  Careful examination can identify those who will benefit from surgery.  The goals for surgery are several: to rebalance muscles in the limb to improve function, to decrease hygiene problems, and to improve cosmesis. In cerebral palsy some muscles are spastic and work out of phase.  Surgery involves decreasing their tone by lengthening the tendons or rerouting them.  This is followed by a course of physiotherapy.  Done for proper indications, surgery for cerebral palsied children yields gratifying results.

Similar problem could result after head injury or in people recovering from stroke.  Due to the improper control of the brain on the muscles there is no coordination in the various muscle groups.  In such people too, surgery could be very useful.  A coordinated effort of the neurologist or neurosurgeon, hand surgeon and physiotherapist is essential.  At Ganga hospital, these procedures are regularly done.