Synopsis ■ Spasticity is a condition characterized by muscle hypertonia, caused by a hyperactive stretch reflex mechanism, usually linked to a central neurological insult. It is responsible for various limb deformities, causing variable functional impairments. ■ Its primary treatment is…
Synopsis ■ Upper extremity ischemia is caused by many etiologies and may be classified into acute and chronic cases. ■ A precise understanding of arterial anatomy is pertinent to preoperative diagnosis, patient selection, and operative procedure. ■ A history of…
Synopsis ■ Free-functioning muscle transfer involves the transfer of a muscle from a distant location to replace a major functional deficit. ■ It is a complex procedure that requires high patient motivation and compliance. ■ The technique involves microvascular anastomoses…
Synopsis ■ Nerve injuries are often devastating, with associated pain and impaired function. ■ Motor nerve injuries must be managed expeditiously, because regenerating axons must reach target muscle prior to degeneration and fibrosis – “time is muscle”. ■ Nerve transfers…
Synopsis ■ A tendon transfer is a reconstructive technique in which the tendon of a functioning muscle is detached, mobilized, and then reattached to another tendon or tendons of a non-functioning muscle, or into bone, to substitute for the action…
Synopsis ■ Suffering a spinal cord injury causes a huge life transition, where simple everyday tasks become a challenge. Patients with tetraplegia rank hand and arm control as their top functional restoration priotity. The primary goal for people with tetraplegia…
Synopsis ■ Brachial plexus injuries (BPI) are characterized by many complex problems and remain a dilemma to many reconstructive microsurgeons. These complexities include: (1) diverse injury patterns; (2) disrupted anatomy; (3) unpredictable nerve degeneration and regeneration; (4) difficult physical examination…
Synopsis ■ Nerve regeneration after injury is orchestrated by delicate processes in neurons, non-neural cells, and other cells at various levels from the periphery to the central nervous system. ■ The clinical effects of a nerve injury include not only…
Synopsis ■ Chronic nerve entrapment syndromes in the upper extremity are common and their occurrence is only likely to increase as risk factors such as diabetes, obesity, and advanced age become more prevalent in the general population. ■ In most…
Synopsis Upper extremity problems that are attributed to the workplace require experience, a knowledge base, and skill set that set them aside from non-occupational injuries. A careful history, physical examination, and knowledge of current evidence is required to evaluate causation.…