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.