Other procedures

Other surgical procedures may be utilized in specific cases:

    Arthrodesis consists in fusing a joint. This results in permanent stiffness of the joint. It is useful to correct a very severe deformity, especially in non-functioning hands. It is utilized mainly at the wrist level, and it can be partial, leaving some motion, or complete, leaving no motion in extension and flexion, but preserving rotation. It is also performed sometimes in the thumb to correct a very deformed or very unstable joint. It is not indicated in the elbow, and very seldom at the shoulder level.
    Arthrolysis means surgical release of a stiff joint. It may be necessary prior to, or at the same time as other procedures when a joint has become rigid as a result of spasticity. After the release, intensive physiotherapy is required, otherwise the stiffness is likely to recur.
    In children some joints may become hyperlax as a result of the muscle imbalance. This occurs mostly at the level of the fingers, resulting in the so-called “swan neck deformity” or at the thumb level, resulting in hyperextension of the middle joint (metacarpo-phalangeal joint).  Stabilization consists in reinforcing the joint ligaments (“ligamentoplasty”), preventing abnormal movement but preserving normal movements.