Use of botulinum toxin to heal atypical pressure ulcers in the palm

Anupam Datta Gupta and David H Wilson
Med J Aust 2020; 212 (2): . || doi: 10.5694/mja2.50452
Published online: 3 February 2020

A 59‐year‐old woman attended our spasticity clinic with treatment‐resistant atypical pressure ulcer in the right hand caused by focal spasticity secondary to upper motor neuron lesion. She had suffered subarachnoid haemorrhage from a ruptured arteriovenous malformation and underwent craniotomy. She was deemed not suitable for structured rehabilitation due to her significant disability and was placed in a residential accommodation. The patient was using an electrical wheelchair and was requiring full assistance with her personal care. She had typical, dense post‐stroke right‐sided spastic hemiplegia. In the upper limb, she had shoulder adduction and internal rotation, elbow flexion, wrist palmar flexion with flexed fingers at the metacarpophalangeal and proximal interphalangeal joints. She had a baclofen pump that controlled her lower limb spasticity.

  • Anupam Datta Gupta1,2
  • David H Wilson1

  • 1 Queen Elizabeth Hospital, Adelaide, SA
  • 2 University of Adelaide, Adelaide, SA


We thank Barbara Brougham for her help with the editing of the manuscript.

Competing interests:

No relevant disclosures.


remove_circle_outline Delete Author
add_circle_outline Add Author

Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Online responses are no longer available. Please refer to our instructions for authors page for more information.