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Master Thesis

Prévision du résultat de neurotomie hypersélective de membre supérieur par bloc moteur intramusculaire chez l'hémiplégique : étude pilote

Abstract : Objective: the aim of the study was to compare the effect of diagnostic upper limb motor block with hyperselective neurotomy surgery associated with tendon and/or bone surgery according to each patient, in the treatment of the spastic upper limb in hemiplegic patients.
Method: in this study of routine care with prospective results, four patients had upper limb nerve block with anaesthetics followed by hyperselective neurotomy surgery with associated surgery on the selected nerve branches. Faced with sensory and motor disorders related to the nerve motor block, the following 12 patients had intramuscular motor blocks followed by hyperselective neurotomy surgery with associated surgery on the selected nerve branches. Fugl-Meyer upper limb, Institut neuro-orthopédique de Montpellier (INOM) score, House score, Enjalbert classification and modified Frenchay Arm Test were evaluated before and after motor block and at six months from surgery.
Results: upper limb impairment and function scores were significantly improved after intramuscular motor block and after neurotomy and associated surgery. Hyperselective neurotomy surgery associated with musculotendinous and/or bone surgery improved the results more than intramuscular motor block but not significantly.
Conclusion: this preliminary study suggests that intramuscular diagnostic motor block and hyperselective neurotomy with associated surgery improve significantly upper limb assessment scores in a similar way in hemiplegic patients. Intramuscular block was well tolerated and we found no adverse effect. Further studies with more subjects and over a longer period of time would be necessary to confirm the results.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03187728
Contributor : Bibliothèque Universitaire de Médecine Nice <>
Submitted on : Thursday, April 1, 2021 - 12:05:45 PM
Last modification on : Tuesday, August 24, 2021 - 3:14:35 AM

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  • HAL Id : dumas-03187728, version 1

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Ludovic Le Goff. Prévision du résultat de neurotomie hypersélective de membre supérieur par bloc moteur intramusculaire chez l'hémiplégique : étude pilote. Médecine humaine et pathologie. 2020. ⟨dumas-03187728⟩

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