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Spasticity and hyperselective neurectomy in the upper limb.

M Gras1, C Leclercq1

  • 1Institut de la main, clinique Bizet, 23, rue Georges-Bizet, 75116 Paris, France.

Hand Surgery & Rehabilitation
|October 17, 2017
PubMed
Summary
This summary is machine-generated.

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Hyperselective neurectomy (HSN) effectively reduces spasticity and improves function in both children and adults. This surgical technique offers a reliable, long-term solution for upper limb spasticity, even in functional hands.

Area of Science:

  • Neurology
  • Orthopedic Surgery
  • Rehabilitation Medicine

Background:

  • Spasticity presents complex challenges in assessment and treatment.
  • Neurectomy, a surgical option for spasticity since 1912, has traditionally been reserved for nonfunctional hands.
  • Advancements in anatomical understanding have refined neurectomy techniques.

Purpose of the Study:

  • To describe the history and anatomical basis of neurectomy.
  • To detail the hyperselective neurectomy (HSN) technique for upper limb nerves (musculocutaneous, median, ulnar).
  • To evaluate the efficacy and durability of HSN in pediatric and adult spastic patients.

Main Methods:

  • Review of neurectomy history and anatomical dissections.
  • Description of the hyperselective neurectomy (HSN) surgical technique.
Keywords:
Hyperselective neurectomyNeurectomieNeurectomie hyperselectiveNeurectomyNeurotomieNeurotomySpasticitySpasticitéUpper limb

Related Experiment Videos

  • Prospective study evaluating spasticity, mobility, performance, and function post-HSN in children and adults.

    • Main Results:

    • HSN demonstrated a reduction in spasticity across targeted functions (elbow extension, wrist extension, supination).
    • Significant improvements were observed in the functional House score.
    • Results showed stability at both short-term (few months) and long-term (12 months) follow-ups.

    Conclusions:

    • Hyperselective neurectomy (HSN) is a reliable therapeutic option for managing upper limb spasticity.
    • HSN improves functional outcomes and is effective even for patients with functional hands.
    • The positive effects of HSN on spasticity and function appear to be durable.