Sequential Cryoneurolysis and Percutaneous Needle Tenotomy for Refractory Wrist Flexor Contracture: A Retrospective Case Series in Stroke and Spinal Cord Injury.
Paul Winston, Hendrik Pepler, Sophie Alexander and 2 others
PMID 42769723WHAT IT FOUND
Patients with chronic wrist flexor contracture had improved passive wrist extension after percutaneous needle tenotomy following cryoneurolysis.
This small case series cannot prove benefit or separate the treatments' contributions.
Key findings
01Percutaneous needle tenotomy was pursued when passive wrist extension remained limited after cryoneurolysis despite reduced tone.
02After tenotomy, the reported cases showed improved wrist extension and lower tone, including full passive wrist range in some cases.
03A patient had persistent localized pain and swelling after tenotomy that required a local steroid injection.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The series included a very small number of patients, so this cannot show how common the effects or harms are. The design was retrospective, and there was no control group or random assignment. Follow-up duration varied across cases. Outcome measures were passive range and tone in hands with little active movement, so function and strength were not well tested. Other treatments, including diagnostic nerve blocks, botulinum toxin, oral prednisone, and physiotherapy, were used, so the effect of any single procedure cannot be separated.
Declared interests
One author received honoraria for speaking engagements and served on an advisory board for Pacira. That author also received funding for investigator-initiated trials from Pacira through his institution. Pacira is named as the supplier of the cryoneurolysis device used.
The easy way to misread this
Do not conclude that this sequence improves hand function or is a proven treatment. The paper is a retrospective case series without a control group, and some patients received other treatments such as diagnostic nerve blocks, botulinum toxin, or oral prednisone, so the contribution of any single component cannot be separated.