Figure Legend: Intrinsic contractures.
This patient sustained a crush injury of the hand, resulting in direct
damage and late fibrosis of all of the intrinsic muscles. The thumb intrinsic
muscles were extruded through burst wounds. Intrinsic contractures produce
metacarpophalangeal joint flexion contractures, first web space contracture
and extension contractures of the interphalangeal joints, all evident in
here. Secondary swan neck deformity of the fingers is also common.
Correction requires extensive release of the intrinsic muscles, and then
cases such as this, first web reconstruction with a flap and opponensplasty.