Surgical Treatment in Post-Stroke Spastic Hands: A Systematic Review
Metadatos
Mostrar el registro completo del ítemAutor
Hurtado Olmo, Patricia; González Santos, Ángela; Pérez de Rojas, Javier; Fernández Martínez, Nicolás Francisco; del Olmo, Laura; Hernández Cortés, Pedro ManuelEditorial
MDPI
Materia
Stroke Muscle spasticity Upper extremity
Fecha
2024-02-07Referencia bibliográfica
Hurtado-Olmo, P.; González-Santos, Á.; Pérez de Rojas, J.; Fernández-Martínez, N.F.; del Olmo, L.; Hernández-Cortés, P. Surgical Treatment in Post-Stroke Spastic Hands: A Systematic Review. J. Clin. Med. 2024, 13, 945. https:// doi.org/10.3390/jcm13040945
Patrocinador
Project “PI20/01574”, funded by Instituto de Salud Carlos III (ISCIII) and co-funded by the European Union; Doctoral Program in Clinical Medicine and Public Health at the University of Granada (Spain)Resumen
Background: For more than two decades, the surgical treatment of post-stroke spastic
hands has been displaced by botulinum toxin therapy and is currently underutilized. Objectives:
This article aimed to assess the potential of surgery for treating a post-stroke spastic upper extremity
through a systematic review of the literature on surgical approaches that are adopted in different
profiles of patients and on their outcomes and complications. Methods: Medline PubMed,Web of
Science, SCOPUS, and Cochrane Library databases were searched for observational and experimental
studies published in English up to November 2022. The quality of evidence was assessed using the
Grading of Recommendations Assessment, Development and Evaluations (GRADE) system. Results:
The search retrieved 501 abstracts, and 22 articles were finally selected. The GRADE-assessed quality
of evidence was low or very low. The results of the reviewed studies suggest that surgery is a
useful, safe, and enduring treatment for post-stroke spastic upper extremities, although most studied
patients were candidates for hygienic improvements alone. Patients usually require an individualized
combination of techniques. Over the past ten years, interest has grown in procedures that act on
the peripheral nerve. Conclusions: Despite the lack of comparative studies on the effectiveness,
safety, and cost of the treatments, botulinum toxin has displaced surgery for these patients. Studies
to date have found surgery to be an effective and safe approach, but their weak design yields only
poor-quality evidence, and clinical trials are warranted to compare these treatment options.