An alternative treatment for contractures of the elderly institutionalized persons: Microinvasive percutaneous needle tenotomy of the finger flexors

Annals of Physical and Rehabilitation Medicine
Alexis SchnitzlerPhilippe Denormandie

Abstract

Almost 10% of older adults in nursing homes have a fixed flexion deformity of the fingers (claw hand). Such contractures have important functional consequences, often leading to hygiene difficulties. Medical treatment (such as botulinum toxin injections, physiotherapy or positioning) is not always effective and surgery is often not possible in such fragile patients. Microinvasive tenotomy with a large needle could be a useful alternative because it can be carried out in an ambulatory setting under local anaesthesia. A single center, retrospective study involving the 2012-2014 database from the day-hospital unit of a neuro-orthopaedic department in France. All patients who underwent percutaneous needle tenotomy of the finger or thumb flexors were included. Outcomes included Goal Attainment Scaling (GAS) and the distance in centimeters between the palm and the pulp of the most flexed digit (PPD). Eighteen patients underwent tenotomy (13 women; mean age: 76±14 years); all patients lived in a nursing home. The limb to be treated was nonfunctional in all patients. The principal goal was determined by consensus with the patients and their health-care teams and was most often to facilitate hand hygiene. Eight patients had at least one...Continue Reading

References

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Citations

Dec 21, 2016·Archives of Physical Medicine and Rehabilitation·Flavia CoroianIsabelle Laffont
Feb 8, 2018·PM & R : the Journal of Injury, Function, and Rehabilitation·Cindy Y LinKelvin T Chew

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