Soft tissue surgery for upper extremity contractures is uncommon or under evaluated, however can improve hygiene, pain and appearance in adults with central nervous system lesions. The goal of such interventions is highly individual, thus goal attainment scaling (GAS) is pertinent to evaluate outcome. The objective of this study was to assess the effect of soft tissue surgery for upper extremity muscle contractures in patients with CNS lesions using GAS.

Retrospective data from 70 interventions were included (63 patients, 23 women). Mean age was 51.3±16.2 years (24.2 to 87.0). The primary goal was to improve hygiene (n=58), pain (n=10) or appearance (n=2). Aetiologies were stroke (n=35), traumatic brain injury (n=16), cerebral anoxia (n=4), neurodegenerative disease (n=6) and cerebral palsy (n=2). The GAS Score was calculated before and 3 months’ post-surgery.

Mean GAS score increased by 1.27 for hygiene, 1.06 for pain and 1.00 for appearance. Mean total GAS score increased by 1.18. The T-score (which took into account the weight of each goal) was 52.29 at three months, corresponding to a “better than expected” outcome.

Soft tissue surgery can effectively improve hygiene, pain and appearance in adults with cerebral damage. The preoperative evaluation should be multidisciplinary. GAS is a useful tool to assess the effectiveness of surgery for these patients. Surgery does not necessarily mean the end of treatment for patients with CNS lesions – post-surgical changes allow new objectives to be determined, which can then be attained through further pharmacologic treatment and rehabilitation.