{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T07:10:29Z","timestamp":1793171429285,"version":"4.5.0"},"reference-count":30,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T00:00:00Z","timestamp":1755043200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Hand Surg Eur Vol"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:p>Hyperselective neurectomy is increasingly recognized as one of the major treatment strategies for spasticity of the upper limb. However, concern remains about postoperative recurrence of the spasticity. In a previous prospective study of 42 patients, we reported significant improvement in spasticity with minor recurrence but overall tone reduction at an average of 31 months post-surgery. In this follow-up study we reassessed a subpopulation of patients from the same cohort to evaluate the long-term efficacy of hyperselective neurectomy. At an average of 53 months post-surgery, the results of 39 patients showed a similar trend to the previous study with significant improvement in the modified Ashworth and Tardieu scale within a year, and this improvement remained stable at the final follow-up. There was also significant improvement in spontaneous posture (mean 75\u201340\u00b0 elbow flexion), with no decline in the range of motion and strength of the operated muscles. Antagonist muscle groups and functional scores demonstrated a general trend towards improvement (House score from 2.2 to 3.4). This study highlights the sustained effectiveness of hyperselective neurectomy on upper limb spasticity more than 4 years after the procedure.<\/jats:p>\n                  <jats:p>\n                    <jats:bold>Level of evidence:<\/jats:bold>\n                    III\n                  <\/jats:p>","DOI":"10.1177\/17531934251363111","type":"journal-article","created":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T11:47:07Z","timestamp":1755085627000},"page":"1448-1455","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":11,"title":["Hyperselective neurectomy for the treatment of upper limb spasticity: a long-term follow-up"],"prefix":"10.1177","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0500-8864","authenticated-orcid":false,"given":"Sze Ryn","family":"Chung","sequence":"first","affiliation":[{"name":"Department of Hand and Reconstructive Microsurgery, Singapore General Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Panciera","sequence":"additional","affiliation":[{"name":"Ospedale Villa Salus, Mestre, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camillo","family":"Fulchignoni","sequence":"additional","affiliation":[{"name":"F. Policlinico Gemelli, Universita Cattolica del Sacro Cuore, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7927-9985","authenticated-orcid":false,"given":"Caroline","family":"Leclercq","sequence":"additional","affiliation":[{"name":"Institut de la Main, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,8,13]]},"reference":[{"key":"e_1_3_4_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/01202412-199801000-00012"},{"key":"e_1_3_4_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00276-019-02380-y"},{"key":"e_1_3_4_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/ptj\/67.2.206"},{"key":"e_1_3_4_5_1","doi-asserted-by":"publisher","DOI":"10.2340\/16501977-0786"},{"key":"e_1_3_4_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.1920040404"},{"issue":"1","key":"e_1_3_4_7_1","article-title":"Etude r\u00e9trospective du r\u00e9sultat \u00e0 long terme des neurotomies s\u00e9lectives p\u00e9riph\u00e9riques dans le traitement du membre sup\u00e9rieur spastique [Retrospective study of the long-term results of selective peripheral neurotomy for the treatment of spastic upper limb]","volume":"55","author":"Buffenoir K","year":"2009","unstructured":"Buffenoir K, Rigoard P, Ferrand-Sorbets S, Lapierre F. Etude r\u00e9trospective du r\u00e9sultat \u00e0 long terme des neurotomies s\u00e9lectives p\u00e9riph\u00e9riques dans le traitement du membre sup\u00e9rieur spastique [Retrospective study of the long-term results of selective peripheral neurotomy for the treatment of spastic upper limb]. 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Hyperselective neurectomy in the treatment of the spastic upper limb. Phys Med Rehabil Int. 2016, 3(1): 1075.","journal-title":"Phys Med Rehabil Int"},{"key":"e_1_3_4_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/17531934241238885"},{"key":"e_1_3_4_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/17531934211027499"},{"key":"e_1_3_4_20_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.2006.104.2.215"},{"key":"e_1_3_4_21_1","doi-asserted-by":"publisher","DOI":"10.1302\/2058-5241.2.160074"},{"key":"e_1_3_4_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00276-015-1593-6"},{"key":"e_1_3_4_23_1","doi-asserted-by":"publisher","DOI":"10.1191\/0269215506cr922oa"},{"key":"e_1_3_4_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00276-015-1448-1"},{"issue":"1","key":"e_1_3_4_25_1","article-title":"Outcome of selective motor fasciculotomy in the treatment of upper limb spasticity","volume":"6","author":"Puligopu AK","year":"2011","unstructured":"Puligopu AK, Purohit AK. Outcome of selective motor fasciculotomy in the treatment of upper limb spasticity. J Pediatr Neurosci. 2011, 6(Suppl 1): S118\u201325.","journal-title":"J Pediatr Neurosci"},{"key":"e_1_3_4_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s007010050127"},{"key":"e_1_3_4_27_1","doi-asserted-by":"publisher","DOI":"10.3340\/jkns.2010.48.3.236"},{"key":"e_1_3_4_28_1","doi-asserted-by":"publisher","DOI":"10.1177\/1753193416641590"},{"key":"e_1_3_4_29_1","article-title":"A la recherche d\u2019une technique de mesure de la spasticit\u00e9 [Research on a technique for measurement of spasticity]","volume":"91","author":"Tardieu G","year":"1954","unstructured":"Tardieu G, Shentoub S, Delarue R. A la recherche d\u2019une technique de mesure de la spasticit\u00e9 [Research on a technique for measurement of spasticity]. 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