Rééducation de la main en pathologies médicale et chirurgicale : ergothérapie, orthèse et kinésithérapie

Dumitrache, Alina; Sanchez, Katherine; Esnouf, Servane; Rören, Alexandra; Vidal, Jean; Rannou, François; Poiraudeau, Serge; Lefèvre-Colau, Marie-Martine

doi:10.1016/j.lpm.2013.01.074

La Presse Médicale

2013

DOI: 10.1016/j.lpm.2013.01.074

|View full text |Cite

Rééducation de la main en pathologies médicale et chirurgicale : ergothérapie, orthèse et kinésithérapie

Alina Dumitrache

Katherine Sanchez²,

Servane Esnouf³

et al.

Help me understand this report

Search citation statements

Order By: Relevance

Paper Sections

Select...

Citation Types

Supporting

Mentioning

Contrasting

Year Published

2013

2023

Publication Types

Select...

Article5

Relationship

Self Cite0

Independent5

Authors

Journals

Cited by 5 publications

(1 citation statement)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Spasticity is observed in many upper motor neuron problems but stroke and cerebral palsy are two of the more common conditions for which BoNT has been used to reduce muscle spasticity, release contractures and improve function [1]. Spasticity in the hand and forearm can be particularly problematic due to the prominent role of the upper extremity in activities of daily living [2]. BoNT exerts its effect at the neuromuscular junction to block acetylcholine release into the synaptic cleft and cause muscle relaxation [3].…”

mentioning

confidence: 99%

Novel Uses for Botulinum Neurotoxin in Upper Limb Surgery

2016

View full text Add to dashboard Cite

To the Editor: Recent years have seen Botulinum Neurotoxin (BoNT) injections emerge as a treatment option in the management of muscle spasticity. Spasticity is observed in many upper motor neuron problems but stroke and cerebral palsy are two of the more common conditions for which BoNT has been used to reduce muscle spasticity, release contractures and improve function [1]. Spasticity in the hand and forearm can be particularly problematic due to the prominent role of the upper extremity in activities of daily living [2]. BoNT exerts its effect at the neuromuscular junction to block acetylcholine release into the synaptic cleft and cause muscle relaxation [3]. Its use is limited by the ability of axons to regenerate at the neuromuscular junction; hence the effects of toxin injections are only temporary. There are also limitations in cases of prolonged muscular contracture which result in postural abnormalities and commonly require corrective surgery. Toxin use is often used as an alternative to tendon lengthening or tendon transfer; however our centre is now implementing a number of novel uses for BoNT injections with a view to improving outcomes in our cerebral palsy patients. We report a 16 year old patient with cerebral palsy who underwent a left flexor carpi radialis (FCR) to extensor carpi radialis longus (ECRL) tendon transfer with release of flexor digitorum superficialis (FDS) and flexor pollicis longus (FPL). Ultrasound guided BoNT injections were administered 2 weeks preoperatively to FCR, FDS, FDP, and FPL. The 2 week delay allowed the BoNT to exert its full effect and achieve a maximum preoperative reduction in muscle tension. We typically use doses of 50 units BoNT per muscle. Our main finding is that BoNT injections can be valuable when used in conjunction with tendon lengthening and tendon transfer techniques, as a combination of surgery and injections produce a synergistic effect. With regards to tendon lengthening in FDS and FPL, preoperative reduction in muscle tension made achievement of optimum tendon length and hand position a more straightforward process. Reduced muscle tension makes the surgeon's task easier and leads to a better postoperative result. This finding supports results in animal models where manipulation of the muscle-tendon unit was made easier by preoperative injection of BoNT [4]. The benefits of this technique are also seen in tendon transfer. Firstly, reducing tension in the transferred FCR tendon allows for an easier transfer, attachment and attainment of an optimum hand position. Secondly, by reducing tension on antagonistic muscles (wrist flexors FDS and FDP), the ability to achieve an optimum hand position is more straightforward and, theoretically, the risk of post operative failure is reduced as the antagonistic force across the transferred tension is less. At present, this technique has been used on a number of patients at our centre and so far the results are promising with the surgeon noting the ease with which a good hand position is achieved intraoperatively co...

show abstract

mentioning

confidence: 99%

Novel Uses for Botulinum Neurotoxin in Upper Limb Surgery

2016

View full text Add to dashboard Cite

show abstract

L’atteinte de la main dans la sclérodermie systémique

Mouthon

2013

La Presse Médicale

View full text Add to dashboard Cite

Hand involvement is very common in patients with systemic sclerosis and represents an important tool for the early diagnosis of the disease. Vascular involvement of the hands is at the forefront of systemic sclerosis, with Raynaud's phenomenon, which may be complicated by digital ulcers, digital necrosis causing pain, infection and significant disability. Joint inflammation can also be disabling and causes the occurrence of contractures and deformities resulting in a marked hand disability. Skin sclerosis involving fingers and hands leads to the occurrence of pain and functional impairment. Hand involvement contributes to 75 % of global disability in patients with systemic sclerosis. Only a comprehensive care, taking into account the vascular, skin and joint manifestations, including physical therapy if needed can improve hand function in patients with systemic sclerosis.

show abstract

La main : un outil pour le diagnostic et l’évaluation du retentissement des maladies

Mouthon

2013

La Presse Médicale

View full text Add to dashboard Cite

scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.

Contact Info

customersupport@researchsolutions.com

10624 S. Eastern Ave., Ste. A-614

Henderson, NV 89052, USA

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Blog Terms and Conditions API Terms Privacy Policy Contact Cookie Preferences Do Not Sell or Share My Personal Information

Made with 💙 for researchers

Part of the Research Solutions Family.

Rééducation de la main en pathologies médicale et chirurgicale : ergothérapie, orthèse et kinésithérapie

Cited by 5 publications

References 39 publications

Novel Uses for Botulinum Neurotoxin in Upper Limb Surgery

Novel Uses for Botulinum Neurotoxin in Upper Limb Surgery

L’atteinte de la main dans la sclérodermie systémique

La main : un outil pour le diagnostic et l’évaluation du retentissement des maladies

Contact Info

Product

Resources

About