Surgical Management of Upper Extremity Deformities in Patients With Upper Motor Neuron Syndrome

摘要

Injury to the central nervous system can create upper extremity deformities and dysfunction, typically caused by a cerebrovascular accident, traumatic brain injury, anoxic brain injury, or spinal cord injury. Regardless of the etiology, disruption of inhibitory upper motor neuron (UMN) pathways can lead to a constellation of symptoms such as muscle weakness, decreased motor control, hyperexcitable tendon reflexes, muscle spasticity, and agonist-antagonist cocontraction that characterizes a condition known as UMN syndrome. The magnitude of neurorecovery varies among patients who have sustained brain injuries and can be classified as having a functional or nonfunctional upper extremity based on the presence or absence of volitional motor control at a specific joint, respectively. Many surgical procedures can be employed to optimize function, decrease pain, improve hygiene, and enhance cosmesis in patients with UMN syndrome. (Copyright (C) 2019 by the American Society for Surgery of the Hand. All rights reserved.)