Surgical Treatment of Pediatric Upper Limb Spasticity: The Wrist and Hand
Surgical Treatment of Pediatric Upper Limb Spasticity: The Wrist and Hand
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DOI：
10.1055/s-0035-1571254
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发表时间：
2016-02-01
影响因子：
2
通讯作者：
Fakhro, Abdulla
中科院分区：
文献类型：
--
作者：
Seruya, Mitchel;Dickey, Ryan M.;Fakhro, Abdulla
手腕和手对于将上肢置于抓握、捏紧和释放活动的功能位置至关重要。这取决于手腕和手的外在和内在肌肉之间的微妙平衡。痉挛改变了这种平衡，限制了上肢与环境的相互作用。通常，患有上肢痉挛的儿科患者会出现手腕弯曲、拇指放在手掌上和手指弯曲的姿势。这些挛缩通常继发于手腕和手的外在屈肌以及拇指和手指的内在肌肉的痉挛。肌腱释放、延长或转移手术可能有助于纠正由此产生的异常姿势。带或不带近行腕骨切除术的全腕关节融合术可能有助于解决严重弯曲的腕部畸形。通过正确的诊断、执行良好的手术计划和一致的手部康复方案，可以获得成功的手术结果。
The wrist and hand are essential in the placement of the upper extremity in a functional position for grasp, pinch, and release activities. This depends on the delicate balance between the extrinsic and intrinsic muscles of the wrist and hand. Spasticity alters this equilibrium, limiting the interaction of the upper limb with the environment. Classically, pediatric patients with upper limb spasticity present with a flexed wrist, thumb-in-palm, and flexed finger posture. These contractures are typically secondary to spasticity of the extrinsic flexor muscles of the wrist and hand and intrinsic muscles of the thumb and digits. Tendon release, lengthening, or transfer procedures may help correct the resultant abnormal postures. A total wrist arthrodesis with or without proximal row carpectomy may help address the severely flexed wrist deformity. With proper diagnosis, a well-executed surgical plan, and a consistent hand rehabilitation regimen, successful surgical outcomes can be achieved.