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Objective: To evaluate whether reconstructive hand surgery could improve the ability of tetraplegic patients to perform clean intermittent self-catheterization (CIC). Materials and methods: The subjects were patients with complete traumatic tetraplegia admitted to the Nagano Rehabilitation Center between 1977 and 1996. A total of 63 subjects were included in this study with an age range of 18 ± 73 years (mean 38.2 years). Reconstructive hand surgery was performed on 44 hands (28 cases). Current urological conditions were assessed by interview or mail questionnaire. Results: Fifty-one per cent (22/43) of the patients with C6 level of tetraplegia and 86% (12/ 14) of those with C7 or C8 neurological level of injury could perform CIC independently and only one subject needed assisted CIC. Conclusion: CIC is the preferred option for people with tetraplegia. Reconstructive hand surgery is thus recommended to make urological management more independent for a selected group of people with tetraplegia. Spinal Cord (2000) 38, 541 ± 545

Two unusual cases of symptomatic partial rupture of the extensor carpi ulnaris tendon associated with ulnar-styloid nonunion are described. Intraoperative findings suggested that the jagged surface of the distal ulna was the cause of flaying. In one case, debridement of the frayed extensor carpi ulnaris tendon and fixation of the ulnar styloid were effective for the relief of symptoms. But after the same procedure in another case, osteosynthesis of the ulnar-styloid could not be attained and tenodesis of the extensor carpi ulnaris tendon to the ulnar head was needed. Partial rupture of the ECU tendon should be taken into account in the differential diagnosis of a patient with ulnar wrist pain after ulnar-styloid fracture.

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