Strong active range of motion is built on the foundation of the goals just described, with the prerequisite of painless stable passive range of motion and the most powerful tool of early active motion. Secondary salvage with tenolysis, joint releases, tendon transfers, and in rare cases free functional muscle transfers may be indicated, but are unlikely to achieve the potential made possible with primary healing and early active motion. Such procedures are contraindicated for patients who have persistent local pain or who have developed a strong pattern of disuse of the hand.
 

e-Hand

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