gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

Surgery for the tetraplegic upper limb – Initial experience and early results

Meeting Abstract

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  • presenting/speaker Erich Mennen - Muelmed Rehabilitation Centre, Pretoria, South Africa

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. DŁsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-1895

doi: 10.3205/19ifssh0989, urn:nbn:de:0183-19ifssh09893

Published: February 6, 2020

© 2020 Mennen.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objectives/Interrogation: The need for upper limb surgery for tetraplegic patients was identified at a large spinal rehabilitation centre. (100 bed unit)

A clinic dedicated to the care of these patients was established in 2013 focussing on a team approach including surgeons, occupational and physiotherapists.

This study is a retrospective review of the first 21 patients treated surgically at our unit.

Methods: Tetraplegic patients are seen once a month at a dedicated clinic for evaluation and possible upper limb surgical reconstruction.

Surgical procedures consisted of either posterior deltoid to triceps, or biceps to triceps transfer for restoration of elbow extension.

Grasp and pinch reconstruction was performed according to principles described as the Alphabet procedure.

Nerve transfers limited to the supinator nerve to the posterior interosseous nerve in selected early cases.

Results and Conclusions: Patients in the biceps to triceps group improved an average of 2 MRC grades of elbow extension.

Grasp reconstruction patients exhibited an improvement in pinch grip and finger flexion power.

All surgeries evaluated according to the Canadian Occupational Performance Measure (COPM).

Nerve transfers performed end to end and encouraging early results achieved.

Surgical reconstruction of the upper limb in tetraplegia is to the benefit of the patient.

Patients express a high level of satisfaction following procedures performed for elbow extension and grasp and pinch reconstruction.

We aim to continue offering upper limb surgery to these patients and hope to improve our approach and techniques.