In a hand with paralysis of the intrinsic muscles, the clawing of the
fingers is associated with deformity of the distal transverse metacarpal
arch. The arch is often flattened in the open-hand position and is
sometimes reversed. Sixteen hands were operated on with a new
tendon-transfer procedure aimed at simultaneous correction of the
deformities of the arch and of the fingers. Adequate restoration of the
arch was attained in all sixteen hands while the deformity and disability
were corrected in 85 per cent of the fingers.