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Hyperselective neurectomy (HSN) procedures in the spastic upper limb aim to reduce tone by excising some branches of the involved peripheral motor nerves, at the point of entry of each motor ramus into the target muscle. In this prospective study, 42 patients with upper limb spasticity were treated by HSN for the muscles of elbow flexion, forearm pronation and wrist flexion and evaluated for their short-term results (average 6 months) and long-term outcomes (average 31 months). Results at both time points showed an effective reduction of the spastic tone, with no decrease of muscle strength in the operated spastic muscles. Comparison of results between the two time points showed durability of the improvement, which remained statistically significant despite a slight relapse in spasticity. The results of HSN compare favourably with the other techniques of partial neurectomy; however, the technique requires a detailed knowledge of upper limb motor anatomy. Level of evidence: II [ABSTRACT FROM AUTHOR]

New surgical techniques for the treatment of scaphoid non-union, developed in the last two decades, now enable a healing rate of 80-90%. However, no consensus exists for the surgical treatment of non-union. On the other hand, regenerative medicine techniques have enriched the therapeutic armamentarium for non-union, especially in the lower limbs, with the use of autologous concentrated bone marrow injection using autologous osteogenic precursors to create a favorable microenvironment for bone healing. This technique has the advantages of being inexpensive, easily accessible and applicable in scaphoid non-union as a biological adjuvant to surgery, to improve both healing times and rates. We report 6-month clinical results for the first patient receiving autologous concentrated bone marrow injection associated to scaphoid screw fixation in our center., (Copyright © 2024. Published by Elsevier Masson SAS.)

Hyperselective neurectomy (HSN) procedures in the spastic upper limb aim to reduce tone by excising some branches of the involved peripheral motor nerves, at the point of entry of each motor ramus into the target muscle. In this prospective study, 42 patients with upper limb spasticity were treated by HSN for the muscles of elbow flexion, forearm pronation and wrist flexion and evaluated for their short-term results (average 6 months) and long-term outcomes (average 31 months). Results at both time points showed an effective reduction of the spastic tone, with no decrease of muscle strength in the operated spastic muscles. Comparison of results between the two time points showed durability of the improvement, which remained statistically significant despite a slight relapse in spasticity. The results of HSN compare favourably with the other techniques of partial neurectomy; however, the technique requires a detailed knowledge of upper limb motor anatomy. Level of evidence: II.