Pronator teres selective neurectomy in children with cerebral palsy

Pronator teres selective neurectomy in children with cerebral palsy The objective of this study was to evaluate the results after selective pronator teres (PT) neurectomy in children with spastic hemiplegia. Patients with PT spasticity without contracture and an active supination improvement after PT botulinum toxin injection were included. Hand function and deformities were evaluated with the House score, Gschwind and Tonkin pronation deformity classification and Zancolli’s classification. Twenty-two patients (mean age 11.6 years) were included in this study. The average follow-up was 32.6 months. All but one patient improved their supination with a preoperative mean active supination of 5° (range −80–70°) and postoperative of 48° (range 10–90°). Active pronation was always maintained at the last follow-up. PT selective neurectomy appears to improve active and passive forearm supination and should be included in a global strategy of treatments to improve upper limb function in children with cerebral palsy.Level of evidence: IV http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Hand Surgery (European Volume): Journal of the British Society for Surgery of the Hand & Official Journal of the Federation of European Societies for Surgery of the Hand SAGE

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Publisher
SAGE
Copyright
© The Author(s) 2018
ISSN
1753-1934
eISSN
2043-6289
D.O.I.
10.1177/1753193418780590
Publisher site
See Article on Publisher Site

Abstract

The objective of this study was to evaluate the results after selective pronator teres (PT) neurectomy in children with spastic hemiplegia. Patients with PT spasticity without contracture and an active supination improvement after PT botulinum toxin injection were included. Hand function and deformities were evaluated with the House score, Gschwind and Tonkin pronation deformity classification and Zancolli’s classification. Twenty-two patients (mean age 11.6 years) were included in this study. The average follow-up was 32.6 months. All but one patient improved their supination with a preoperative mean active supination of 5° (range −80–70°) and postoperative of 48° (range 10–90°). Active pronation was always maintained at the last follow-up. PT selective neurectomy appears to improve active and passive forearm supination and should be included in a global strategy of treatments to improve upper limb function in children with cerebral palsy.Level of evidence: IV

Journal

Journal of Hand Surgery (European Volume): Journal of the British Society for Surgery of the Hand & Official Journal of the Federation of European Societies for Surgery of the HandSAGE

Published: Oct 1, 2018

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