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Contiure progression of isotonic strengthening

Osseointegration has made possible the development of a number of clinical applications in the field of hand surgery and orthopaedics. There are a number of conditions and diseases that represent a major challenge in relation to rehabilitation and restoring lost function. These include the rheumatoid arthritis patient in whom the destruction of the synovial joints is a particularly challenging problem for the orthopaedic surgeon and hand surgeon. The treatment of destroyed metacarpophalangeal joints in the hand has been achieved through the use of osseointegration, whereby titanium fixtures are installed in the phalangeal and metacarpal bones and linked by a joint prosthesis. This allows the severely deformed hand to be reconstructed to allow a more normal anatomical appearance and also to obtain major improvement of hand function. Other major challenges in orthopaedics and hand surgery relate to the amputation of digits and upper and lower limbs. Amputations have been performed for much of human history, mostly following trauma as a salvage procedure carried out for the treatment of war victims. Today, the majority result from vascular disorders such as atherosclerosis and diabetes, and from tumor, although trauma still remains a major cause. Examples of osseointegration solutions to these problems are outlined in the following sections