As mentioned above, the injured hand tends to become stiff in a characteristic position due to the anatomy and soft tissue constraints of each joint. After a period of swelling and immobility, it is common to be faced with flexion contractures of the interphalangeal joints, extension contractures of the metacarpophalangeal joints, and pronation contracture of the forearm. Less frequently recognized, but equally common and important are intrinsic muscle contractures of the hand and adduction contracture of the first web space. These structures should be specifically stretched and length maintained as much as possible during recovery. Stable skeletal fixation, anatomic joint reconstruction, early wound healing and early range of motion are key to preserving the potential motion of all moving structures. As elsewhere, early range of motion after injury promotes synovial surface healing, reduces the tethering effects of adhesions and mai ntains the necessary dimensions of the joint capsule.
 

e-Hand

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