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Published on: October 29, 2021
Musculotendinous Lengthening Procedures and Tendon Transfers for Upper Limb Spasticity
Bertrand Coulet1, Pierre Louis Coulet1, Pierre Emmanuel Chammas1
1Service de Chirurgie de la main et du Membre Supérieur, Chirurgie des Paralysies, Lapeyronie University Hospital, Montpellier, France.
Hand Surgery & Rehabilitation
|July 31, 2026
Summary
Central paralyses present complex motor deficits. A new evaluation score (INOM) aids in surgical planning for tendon transfers, improving grasp and function by prioritizing treatment needs.
Area of Science:
- Orthopedics
- Neurology
- Rehabilitation Medicine
Background:
- Central paralyses cause motor deficits, spasticity, and contractures, complicating assessment and treatment.
- Tendon transfers for central paralysis are limited and part of complex surgical programs.
Purpose of the Study:
- To propose an evaluation method using the INOM score for surgical planning in central paralysis.
- To improve grasp and functional outcomes through targeted interventions.
Main Methods:
- Developed the INOM score based on prognostic factors and surgical correction parameters.
- Utilized anesthetic blocks and botulinum toxin injections to assess spasticity.
- Evaluated indications for tendon transfers in conjunction with other surgical techniques.
Main Results:
- The INOM score prioritizes treatment, guiding surgical strategy development.
- Distinguishing spasticity from contracture is crucial for effective treatment.
- Tendon transfers can restore function and prevent deformity.
Conclusions:
- The INOM score provides a structured approach to managing central paralysis.
- A comprehensive surgical strategy combining various techniques is essential.
- Tendon transfers play a vital role in functional restoration and deformity prevention.
