Quotation from: Manual of Surgery

Written by: Alexander Miles and Alexis Thomson


Finally, in cases in which the paralysis is permanent and incurable, the
disability may be relieved by operation. A fascial graft can be employed
to act as a ligament permanently extending the wrist; it is attached to
the third and fourth metacarpal bones distally and to the radius or ulna
proximally. The flexor carpi radialis can then be joined up with the
extensor digitorum communis by passing its tendon through an aperture in
the interosseous membrane, or better still, through the pronator
quadratus, as there is less likelihood of the formation of adhesions
when the tendon passes through muscle than through interosseous
membrane. The palmaris longus is anastomosed with the abductor pollicis
longus (extensor ossis metacarpi pollicis), thus securing a fair amount
of abduction of the thumb. The flexor carpi ulnaris may also be
anastomosed with the common extensor of the fingers. The extensors of
the wrist may be shortened, so as to place the hand in the position of
dorsal flexion, and thus improve the attitude and grasp of the hand.

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