[The musician's hand: aspects of music physiology and performing arts medicine].

Musicians are particularly demanding hand patients. Increased expectancy towards the hand surgeon as well as principle aversion to any kind of operative treatment of the musician's hand impede the relationship between hand surgeon and patient. Knowledge and experience of the specific demands towards the musician's hand--including the background of basics in physiology of music making and instrumental techniques--facilitate history taking, examinations, diagnosing as well as the selection of therapy. Besides tendinitis and tendovaginitis, pathologies of the musician's hand are not more frequent compared to the entire population. Still several pathologies reach a significantly pronounced importance through the specific professional requirements. This is true especially for peripheral nerve compression syndromes, arthritis, ganglia, contractures, joint laxity and focal dystonias. The treatment of these disorders and hand trauma require, besides an utmost of hand surgical care, creativity and the implementation of the professional musical surroundings in therapy and rehabilitation, including also the musical instruments. The indication for surgery might be restrained in certain cases, although there are, without doubt, situations, when a professional musician should be operated on at an early stage. This should enhance a rapid return to play the musical instrument and to exercise delicate and demanding skilled movement patterns of his hand.