Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA.
J Hand Surg Eur Vol. 2020 Jan;45(1):34-42. doi: 10.1177/1753193419878973. Epub 2019 Oct 9.
Surgical interventions for the spastic upper extremity secondary to stroke, traumatic brain injury, and cerebral palsy aim to correct the common deformities of elbow flexion, forearm pronation, wrist and finger flexion, ulnar deviation, and thumb-in-palm deformity. After appropriate evaluation, as well as determining the goals of surgery, deformity correction can be achieved through single-event, multi-level surgery. Surgery includes a combination of soft tissue lengthening, tendon transfer, and joint stabilization procedures. Surgical treatment for shoulder adduction/internal rotation, elbow flexion, forearm pronation, wrist flexion, thumb-in-palm, and clenched fist deformities due to spasticity are discussed, and treatment outcomes are reviewed.
针对因中风、颅脑损伤和脑瘫引起的上肢痉挛性疾病，手术干预的目的是纠正常见的肘部屈曲、前臂旋前、腕部和手指屈曲、尺侧偏斜以及手握拳畸形。经过适当的评估以及确定手术目标后，可通过单次多平面手术来矫正畸形。手术包括软组织延长、肌腱转位和关节稳定等多种方法。本文讨论了由于痉挛导致的肩部内收/内旋、肘部弯曲、前臂旋前、腕部弯曲、手握拳和紧握拳畸形的手术治疗，并回顾了治疗结果。
