Multilevel functional surgery in adults with acquired spasticity of upper extremity

The authors present their expertise in the treatment of acquired spasticity of the upper extremity in adults, illustrating the basics of modern functional surgery, which benefits from the achievements in bioengineering and information technology and new surgical techniques. Moreover close cooperation between the physical therapist and surgeon is essential in planning a new treatment scheme which, when possible, may successfully strengthen and optimize the function control of the remaining extremity, thus overriding the old concept of merely correcting the deformity. Results depend on proper scrutiny of the preoperative clinical and instrumental details on successful surgical accomplishment of a balance between static and dynamic forces implied in spasticity, and on the implementation of appropriate splinting and a highly individualized and concentrated rehabilitation schedule. The authors highlight the necessity to create cross-specialty working teams in the treatment of spasticity, following the guidelines defined by different scientific teams.