Clinical Recovery of Spastic Finger Flexion Using Hyperselective Neurectomy: A Case Series.

Purpose: Hyperselective neurectomy (HSN) is an advanced peripheral nerve ablation procedure that can relieve spasticity and enhance the quality of life in patients with spasticity following upper motor neuron injuries. The main advantage of HSN is that it can treat spasticity as well as preserve hand function. Thus, HSN may be the procedure of choice in patients with spastic functional hands. In this study, we present the surgical technique and results of HSN of the flexor digitorum superficialis (FDS) in the setting of spastic finger flexion.
Methods: HSN of the FDS was performed on 18 patients with functional hands. We employed the Peraut and House categorizations to evaluate pain reduction and improvement of hand function, respectively.
Results: The patients exhibited marked improvement in finger spasticity following HSN. Finger function was preserved, and all patients demonstrated improved hand function, as evidenced by an increase in the House Score from 0 to 2 before surgery to a range of 4 to 8 after the intervention. All patients experienced relief from pain.
Conclusions: HSN of the FDS branch is a technique that should be considered to reduce finger flexor spasticity and preserve finger flexion function.
Type of Study/level of Evidence: Therapeutic IV.
(Copyright © 2023 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.)