Restoration of Function to Congenitally Deformed Hands. Part I

摘要

The objectives of the study were: (1) to develop an effective system for classifying congenital anomalies of the hand, and (2) to develop a method of testing functional disabilities of the hand. A classification system based on that devised by the American Society for Surgery of the Hand was developed. Groups of physicians in several foreign countries cooperated with four U. S. teams in testing the classification system. It was shown that the accuracy in the use of the classification system improved with knowledge and that there was no statistically significant differences in the success rates between those who use English as their prime language and those who do not. After a review of the literature, and based on previous experience gained in testing adult hands, a preliminary evaluation scheme was devised consisting of: a muscle test; a recording of the passive range of motion; a measurement of the basic types of grip; a sensory evaluation; and a measurement of hand size. Experience forced extensive modification of the evaluation scheme as originally conceived. The muscle test was deleted because variations in the anatomy of the musculature of the congenitally deformed arm and hand produced a high degree of unreliability.