stroke upper limb paralysis
Conditions
Interventions
surgery group:contralateral C7 nerve transfer to ipsilateral C8
Sponsors
Department of Hand Surgery, Huashan Hospital, Fudan University
Eligibility
Sex/Gender
All
Age
18 Years to 60 Years
Inclusion criteria
Inclusion criteria: 1) Spastic hemiplegia of one upper limb caused cerebral hemorrhage, cerebral infarction, traumatic brain injury, encephalitis, cerebral palsy, etc; 2) Preoperatively, shoulder elbow function was good (shoulder elbow spasm score below level 1, shoulder joint active range of motion above 130 degrees, elbow joint active range of motion above 90 degrees), severe wrist and finger flexor spasm: wrist flexion spasm, finger joint flexion spasm, and thumb adduction spasm reached the modified Ashworth scale level 3-4; 3) Preoperative palmar ulnar sensory decline (sensory score below S3, significant decrease or disappearance of pain, warmth, and tactile sensation, or two-point discrimination greater than 8mm); 4) Under the age of 60, with onset of illness for more than one year; Although the function of hemiplegic upper limbs has undergone formal rehabilitation training, there has been no significant improvement in the past six months, and the recovery has entered a plateau period; Has a desire for further recovery through surgery; 5) Preoperative evaluation confirmed normal cortical function on the healthy side. 6) Patient or guardian voluntarily agree to participate in the study and sign an informed consent form.
Exclusion criteria
Exclusion criteria: 1) Have serious systemic diseases, such as hypertension, heart disease symptoms, diabetes, undiagnosed liver diseases or disorders (based on serum liver enzyme test results), kidney diseases or renal dysfunction, severe anemia, history of deep vein thrombosis, pulmonary artery thrombosis or cerebrovascular accident, cancer; 2) Patients who cannot take care of themselves in daily life, such as those who cannot walk independently; 3) Recurrent acute bleeding or infarction; 4) Excluding flexor tendon contractures caused by forearm trauma and bone joint abnormalities; 5) Severe upper limb joint contracture or joint deformity on the affected side; 6) The patient suffers from severe, untreated neurological and psychiatric disorders that prevent normal communication; 7) Patients or their family members request cessation of surgery or treatment due to personal reasons.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| active range of motion;Spasticity; | — |
Secondary
| Measure | Time frame |
|---|---|
| upper limb Fugl-Meyer score;HS scale; | — |
Countries
China
Contacts
Public ContactYun-Dong Shen; Wen-Dong Xu
Department of Hand Surgery, Huashan Hospital, Fudan University
Outcome results
None listed