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Selective release of the digital extensor hood to reduce intrinsic tightness in tetraplegia.

Reinholdt C, Fridén J - J Plast Surg Hand Surg (2011)

Bottom Line: Long fingers were consistently the most affected digits.The intrinsic tightness was released completely in all patients and the range of motion (ROM) was improved by 25%, and up to 45% in mild and severe cases, respectively.The good immediate effects of treatment as shown by increased ROM remained intact by 6 months postoperatively.

View Article: PubMed Central - PubMed

Affiliation: National Center of Reconstructive Hand Surgery in Tetraplegia, Department of Hand Surgery, Sahlgrenska University Hospital, Göteborg, Sweden. carina.reinholdt@vgregion.se

ABSTRACT
Patients with tetraplegia may have various degrees of spasticity in the hand ranging from a completely clenched fist to reduced control of grip at triggered spasticity. The objective of the present study was to evaluate the functional effect of the distal ulnar intrinsic release procedure to reduce intrinsic tightness. Seventeen patients with tetraplegia (37 fingers) and with prominent intrinsic tightness were operated on for distal intrinsic release with a modification of the procedure to include only the ulnar side of the proximal phalanx. All the patients had more pronounced tightness on the ulnar than on the radial side of the affected finger. Long fingers were consistently the most affected digits. The intrinsic tightness was released completely in all patients and the range of motion (ROM) was improved by 25%, and up to 45% in mild and severe cases, respectively. The good immediate effects of treatment as shown by increased ROM remained intact by 6 months postoperatively. These data suggest that the distal ulnar intrinsic release procedure is a simple and valuable way of reducing intrinsic tightness and improving hand function and grip for patients with intrinsic tightness. This procedure can be added to other procedures such as lengthening and transfer of tendons.

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Related in: MedlinePlus

Mean (SD) results over time at follow-up at 1, 3, and 6 months. The biggest improvement of range of motion was during the first month after the operation.
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fig4: Mean (SD) results over time at follow-up at 1, 3, and 6 months. The biggest improvement of range of motion was during the first month after the operation.

Mentions: Data are presented as mean ± SD. In addition to the metadata from each specimen for which only descriptive statistics were calculated (Figure 4), range of motion for all fingers in the PIP joint was analysed across the two groups (mild and severe). These data were screened for normality, and skewed to justify the use of a parametric one-way analysis of variance (ANOVA) with severity serving as the two repeated measures. For the individual fingers (index, long, and ring fingers), the Mann-Whitney test was used to assess the final effect of treatment (6 months) within the two severity groups. Significance level (α) was set to 0.05 for all statistical tests.


Selective release of the digital extensor hood to reduce intrinsic tightness in tetraplegia.

Reinholdt C, Fridén J - J Plast Surg Hand Surg (2011)

Mean (SD) results over time at follow-up at 1, 3, and 6 months. The biggest improvement of range of motion was during the first month after the operation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3104283&req=5

fig4: Mean (SD) results over time at follow-up at 1, 3, and 6 months. The biggest improvement of range of motion was during the first month after the operation.
Mentions: Data are presented as mean ± SD. In addition to the metadata from each specimen for which only descriptive statistics were calculated (Figure 4), range of motion for all fingers in the PIP joint was analysed across the two groups (mild and severe). These data were screened for normality, and skewed to justify the use of a parametric one-way analysis of variance (ANOVA) with severity serving as the two repeated measures. For the individual fingers (index, long, and ring fingers), the Mann-Whitney test was used to assess the final effect of treatment (6 months) within the two severity groups. Significance level (α) was set to 0.05 for all statistical tests.

Bottom Line: Long fingers were consistently the most affected digits.The intrinsic tightness was released completely in all patients and the range of motion (ROM) was improved by 25%, and up to 45% in mild and severe cases, respectively.The good immediate effects of treatment as shown by increased ROM remained intact by 6 months postoperatively.

View Article: PubMed Central - PubMed

Affiliation: National Center of Reconstructive Hand Surgery in Tetraplegia, Department of Hand Surgery, Sahlgrenska University Hospital, Göteborg, Sweden. carina.reinholdt@vgregion.se

ABSTRACT
Patients with tetraplegia may have various degrees of spasticity in the hand ranging from a completely clenched fist to reduced control of grip at triggered spasticity. The objective of the present study was to evaluate the functional effect of the distal ulnar intrinsic release procedure to reduce intrinsic tightness. Seventeen patients with tetraplegia (37 fingers) and with prominent intrinsic tightness were operated on for distal intrinsic release with a modification of the procedure to include only the ulnar side of the proximal phalanx. All the patients had more pronounced tightness on the ulnar than on the radial side of the affected finger. Long fingers were consistently the most affected digits. The intrinsic tightness was released completely in all patients and the range of motion (ROM) was improved by 25%, and up to 45% in mild and severe cases, respectively. The good immediate effects of treatment as shown by increased ROM remained intact by 6 months postoperatively. These data suggest that the distal ulnar intrinsic release procedure is a simple and valuable way of reducing intrinsic tightness and improving hand function and grip for patients with intrinsic tightness. This procedure can be added to other procedures such as lengthening and transfer of tendons.

Show MeSH
Related in: MedlinePlus