Surgical Management of Spasticity of the Forearm and Wrist

Hand Clin. 2018 Nov;34(4):487-502. doi: 10.1016/j.hcl.2018.06.006.

Abstract

Upper extremity spasticity may result from a variety of types of brain injury, including cerebral palsy, stroke, or traumatic brain injury. These conditions lead to a predictable pattern of forearm and wrist deformities caused by opposing spasticity and flaccid paralysis. Upper extremity spasticity affects all ages and sociodemographics and is a complex clinical problem with a variety of treatment options depending on the patient, the underlying disease process, and postoperative expectations. This article discusses the cause, diagnosis, operative planning, operative techniques, postoperative outcomes, and rehabilitation protocols for the spastic wrist and forearm.

Keywords: Cerebral palsy; Forearm spasticity; Stroke; Tendon transfer; Traumatic brain injury; Upper extremity spasticity surgery; Wrist spasticity.

Publication types

  • Review

MeSH terms

  • Arthrodesis
  • Forearm / physiopathology
  • Forearm / surgery*
  • Humans
  • Muscle Spasticity / physiopathology
  • Muscle Spasticity / surgery*
  • Muscle, Skeletal / physiopathology
  • Muscle, Skeletal / surgery
  • Physical Examination
  • Tendon Transfer
  • Tendons / surgery
  • Wrist Joint / physiopathology
  • Wrist Joint / surgery*