When _operative treatment_ is called for, it takes the form of osteotomy of the radius and ulna about an inch or more above their articular surfaces. #Congenital dislocation of the wrist# is rare. #Deformities of the Fingers.#--Various forms of _congenital dislocation_ of the fingers are met with, but they are of little clinical importance, as they interfere but slightly with the usefulness of the digit affected. _Congenital lateral deviation of the phalanges_ is more unsightly than disabling; it is met with chiefly in the thumb, in which the terminal phalanx deviates to the radial or to the ulnar side in extension; the deviation disappears on flexion. _Congenital contraction of the fingers_ is comparatively common. It is an inherited deformity, and is often met with in several members of the same family. It most frequently affects the little or the ring and little fingers (Fig. 172), and is usually bilateral. The second and third phalanges are flexed towards the palm; the first phalanx is dorsiflexed, this being the reverse of what is observed in Dupuytren's contraction. Duncan Fitzwilliams suggests that it should be called "hook-finger," and that it is probably due to imperfect development of the anterior ligament of the first inter-phalangeal joint. He has observed it in association with laxity of the ligaments of the other joints of the body. [Illustration: FIG. 172.--Congenital Contraction of Ring and Little Fingers.] The affection is usually disregarded in infancy and childhood as being of no importance. In young children, the deformity is corrected by wearing a light splint fixed with strips of plaster, or a piece of whalebone or steel inside the finger of a glove. In older children, the finger may be straightened by subcutaneous division of the ligament over the palmar aspect of the base of the middle phalanx, or failing this by lengthening the flexor tendons and resecting a wedge from the dorsal aspect of the first phalanx close to the inter-phalangeal joint. #Dupuytren's Contraction.#--This is an acquired deformity resulting from contraction of the palmar fascia and its digital prolongations (Fig. 173). It is rare in childhood and youth, but is common after middle life, especially in men. It is often hereditary, and is said to occur in those who are liable to gout and to arthritis deformans. While it is met with in the working-classes and attributed to the pressure of some hard object on the palm of the hand--such as a hammer or shovel or whip--its greater frequency in those who do no manual work, and the fact that it is very often bilateral, indicate that the constitutional factor is the more important in its causation. [Illustration: FIG. 173.--Dupuytren's Contraction.]