Upper Limb Reconstruction in Persons with Tetraplegia
Tetraplegia is challenging to treat and requires a team of competent and caring physicians and nurses. The initial goal is to facilitate the transition from able-bodied life to a life complicated by spinal cord injury. The issues are enormous and the task seems overwhelming to the patient. Through a series of small steps, the patient is often able to make the changeover. However, complications are endemic including depression, spasticity, autonomic dysreflexia, urinary retention, and decubiti. As part of the rehabilitation, an assessment of the upper extremities is integral. Many patients can benefit from tendon transfers to improve motion and function. The potential to restore elbow extension, wrist extension, pinch, and grasp is critical for independence and spontaneity. This chapter will discuss the evaluation, treatment regimen, and surgical techniques applicable to the person with spinal cord injury.
KeywordsSpinal Cord Injury Functional Electrical Stimulation Biceps Tendon Tendon Transfer Wrist Extension
AVI file: 700423 kB
WMV file: 4037 kB
- Kozin SH. Surgical management of the upper limb after spinal cord injury. In: Trumble TE, Budoff JE, editors. Hand surgery update. Rosemont: American Society for Surgery of the Hand; 2007. p. 777–99.Google Scholar
- Kozin SH, Zlotolow DA. Biceps rerouting and biceps-to-triceps for persons with spinal cord injury. In: Van Heest A, Goldfarb CA, editors. Tendon transfer surgery of the upper extremity: a master skills publication. Rosemont: American Society for Surgery of the Hand; 2012. p. 111–20.Google Scholar
- Yang ML, Li JJ, Zhang SC, Du LJ, Gao F, Li J, Wang YM, Gong HM, Liang Cheng L. Functional restoration of the paralyzed diaphragm in high cervical quadriplegia via phrenic nerve neurotization utilizing the functional spinal accessory nerve. J Neurosurg Spine. 2011;15:190–4.PubMedCrossRefGoogle Scholar