[Fifty years of plastic surgery in the Netherlands. VII. Hand surgery].

The first and second world wars were responsible for a turbulent development of surgery of the hand. The sixties and seventies were marked by the emergence of microsurgery, growing of the knowledge of functional anatomy and use of vascularized skin flaps and joint prostheses. These days hand surgery is mainly concentrated in 'hand centres', with co-operation of a plastic surgeon, physical and occupational therapists and rehabilitation specialists. In the future much can be expected from the genetic and metabolic manipulation of congenital malformations and acquired deformities.