[Is a dynamic or stable technique needed for metacarpophalangeal joints of the hand in ulnar nerve palsy?].

Introduction: It seems interesting to choose between the dynamic and the static techniques for the rehabilitation of the hand suffering from an ulnar nerve palsy on the basis of the grasp (F1) and pinch (F2) strengths which are important in this rehabilitation.

Methods: From june 1997 to december 2001, 30 ulnar palsies all post traumatic with non complicated claw deformities have been collected and distributed in three groups of ten patients. In the group A only the static techniques have been used on the MP joints of the fourth and fifth digits and the thumb; in the group B only the dynamic techniques have been used on the fourth and fifth digits, on the flexor pollicis brevis and on the first dorsal interosseous muscle; in the group C, the MP joint of the thumb has been stabilized and dynamic techniques have been used on these two muscles, the MP joints of the fourth and fifth digits have been only stabilized. The techniques used in this study were among the most popular. The grasp and pinch strengths were measured by a mechanical dynamometer at the preoperative period and at third and sixth postoperative month.

Results: At sixth month, in the group A, F1 didn't change and F2 has increased by 9%; in the group B, F1 has decreased by 24% without recovery of the preoperative value and F2 has increased by 13%; in the group C, F2 has increased by 19%.

Discussion: For a reconstruction of an useful hand in an ulnar nerve palsy, the best solutions seem: for the fourth and fifth digits: simple stabilization of the MP joints for the thumb: an association of this stabilization and a rehabilitation of some muscles involved in the pinch prehension.