Docteur Mathilde GRAS

Membre du bureau de la Société Française de Chirurgie de la Main

Présidente de la Clinique du Poignet - International Wrist Center 

 Ancienne chef de clinique des universités
 Ancienne assistante des Hôpitaux du CHU de Lyon

Prise de Rdv en ligne

 Formation
 Titres et travaux


Actualités en chirurgie de la main

Conduite à tenir devant un poignet traumatique à radiographie initiales normales

Mathilde GRAS

les bonnes pratiques en traumatologie du sport, ADRETS

Sauramps (J. Rodineau)

p 282-292

 

Hyperselective neurectomy fort he treatment of upper limb spasticity in adults and children: a propsective study

C. Leclercq, A. Perruisseau-Carrier, M. Gras, P Panciera, C. Fulchignoni, M. Fulchignoni; J Hand Surg Eur vol 2021 jul



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.

 

Pathologies