Most of the reconstructive procedures of the hand which are employed in permanent nerve paralysis, discussed in this paper, have been employed previously, but some of them are new. For a transplantation to be successful, one must first mobilize the joint, eliminate scar tissue, and then transplant a normally functioning tendon and muscle through normal tissue. Flexors can be transplanted to extensors and extensors to flexors, with excellent results. In most instances, the muscle transplanted should be the one which is most. readily available and which has a range of motion as nearly as possible like that of the muscle and tendon it is intended to replace.