Zlotolow Dan A
Department of Orthopaedics, The Hospital for Special Surgery, 535 East 70th Street, New York City, NY 10021, USA; Shriners Hospital for Children Philadelphia, 3551 North Broad Street, Philadelphia, PA 19140, USA.
Hand Clin. 2018 Nov;34(4):511-516. doi: 10.1016/j.hcl.2018.06.008. Epub 2018 Aug 18.
Although spastic conditions often involve the shoulder, it is rare for surgical intervention to be required. In cases in which chemodenervation and therapy are insufficient to optimize the patient's function or minimize their care requirements, surgical options, such as tendon and joint releases, can be considered. Tendon transfers are rarely indicated. Nerve transfers, particularly contralateral C7, may play a larger role in the future as we gain further understanding into the risks, indications, and contraindications of this exciting technique.
尽管痉挛状态常累及肩部,但需要手术干预的情况很少见。在化学去神经支配和治疗不足以优化患者功能或减少其护理需求的情况下,可以考虑手术选择,如肌腱和关节松解。肌腱转移很少有指征。随着我们对这种令人兴奋的技术的风险、指征和禁忌证有更深入的了解,神经转移,尤其是对侧C7神经转移,可能在未来发挥更大的作用。