Re-enablement of the neurologically impaired hand – 1: terminology, applied anatomy and assessment. Report of a Surgical Workshop held at Green Pastures Hospital and Rehabilitation Centre, November 2004, Pokhara, Nepal

A workshop on the re-enablement of the neurologically impaired hand was held at Green Pastures Hospital and Rehabilitation Centre, Pokhara, Nepal, with the following aims: (a) to exchange ideas and techniques between experienced leprosy surgeons from different countries and continents about assessment and surgical reconstruction of the primary and secondary impairments of the neurologically impaired hand and (b) to develop a document with best practice recommendations and areas for further research. A similar workshop was organized in 2000 on the neurologically impaired foot. The proceedings of this workshop have subsequently been published. For proper understanding of the primary and secondary impairments and their assessment, it is mandatory that there is consensus about terminology and adequate understanding of (patho) kinesiology of the hand. These will be discussed in the first part of this report. The second part of the report will discuss surgical techniques as they relate to the primary and secondary impairments.