Epidermolysis bullosa can produce loss of hand function by contracture and ensheathment of the digits. Of twenty-three patients with this disease, fourteen were evaluated concerning hand function. Surgery was utilized in six patients to release contractures. Removal of the cocoon of epidermis was ineffective alone. Free skin grafts were used in five patients and they healed satisfactorily. Pedicle flaps from the torso gave some prehension in two patients.
Appropriate surgery, followed by careful postoperative splinting and exercises, can give a reasonable range of motion which will permit basic hand function.