Injured metamere and functional surgery of the tetraplegic upper limb

Coulet, Bertrand; Allieu, Y.; Chammas, Michel

doi:10.1016/s0749-0712(02)00020-3

Cited by 63 publications

(38 citation statements)

References 20 publications

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“…It is obvious that the results of the lasso operation may be sometimes disappointing. We agree with Coulet et al [18] that the main prognosis factor is the length of the injured spinal cord metamere. When the injured metamere is long, doing an intrinsic palliative procedure on the fingers is theoretically more important than when it is short, because the hand is totally denervated and deformed.…”

Section: Strategy: Comparison With Published Datasupporting

confidence: 93%

Upper limb surgery for tetraplegia: Assessment of a 10-point strategy

Revol

Cormerais²,

Laffont

et al. 2008

Chirurgie de la Main

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Section: Strategy: Comparison With Published Datasupporting

confidence: 93%

Upper limb surgery for tetraplegia: Assessment of a 10-point strategy

Revol

Cormerais²,

Laffont

et al. 2008

Chirurgie de la Main

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“…For example, the lower motor neuron integrity of intrinsic muscles of the hand may have a strong influence on the quality of the results after tendon transfer and the probability of claw deformities. 38 Restoration of intrinsic balance of the hand could thus be refined (indications and techniques) if precise results concerning the posture of the hand during the grasp were known.…”

Section: Importance and Function Of An Active Elbow Extensormentioning

confidence: 99%

How do C6/C7 tetraplegic patients grasp balls of different sizes and weights? Impact of surgical musculo-tendinous transfers

et al. 2007

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Study design: Prospective control cohort study. Objectives: To develop a new test to analyse qualitatively grasping strategies in C6/C7 tetraplegic patients, and to quantify the effect of musculo-tendinous transfers. Setting: France. Methods: Twelve C6/C7 tetraplegic adults (17 arms; 31.377.9 years) and 17 healthy subjects (30.979.4 years) completed the study. We assessed participants' ability to grasp, move and release standardized balls of variable sizes and weights. Outcome measures: Failures, movement duration (MD), grip patterns, forearm orientation during transport. Results: In patients as well as in controls, the number of digits involved in prehension increased proportionally to the size and weight of the ball. C6 non-operated tetraplegic patients failed 38.2% of the tasks. They frequently used supine transport (51.4% of successful tasks). MD was longer, with a large distribution of values. The presence of active elbow extension poorly influenced the amount of failure nor grip configuration, but significantly reduced MD and supine transport (34%). Patients who were evaluated after hand surgery showed a trend towards improved MD and more frequent completion (failure 30%), especially for middle-sized and middle-weighted balls. Grip patterns were deeply modified, and all transports were made in pronation. Conclusion: The 'Tetra Ball Test' evidences the characteristics of grasping in tetraplegic patients and those influenced by surgery. It may be useful in understanding effects of surgical procedures. This preliminary study must be completed to evaluate the quantitative responsiveness and reproducibility of this test and to develop instrumented electronic balls to optimise it.

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“…Often, the relationship between the level of skeletal injury and level of neurological impairment is not accurate, and this level can also vary between the 2 upper limbs. 7 Muscle strength at the injury level can improve. Usually, this improvement is completed by 1 year after the injury, so we should not consider surgery before this time.…”

Section: Introductionmentioning

confidence: 99%

Biceps to Triceps Transfer in Tetraplegic Patients

Medina

Marcos-García

Jiménez

et al. 2016

Hand (New York, N,Y.)

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Background: Management and indications for surgery in the tetraplegic patient are highly complex because of the substantial functional deficits that they present and their effect on their daily activity. Our purpose was to evaluate the functional outcome in tetraplegic patients who underwent biceps-to-triceps transfer surgery according to Zancolli's modified technique. Methods: This is a retrospective study of 6 biceps-to-triceps transfers using Zancolli's modified technique in 4 patients. Mean follow-up was 45 months. We evaluated each patient's DASH (Disabilities of the Arm, Shoulder and Hand) score before surgery and 12 months later. Results: In the 6 arms that underwent surgery, full and active elbow extension against gravity at 12 months after surgery was achieved. The mean DASH score was 73.2 preoperatively and 20.8 twelve months postoperatively. One complication occurred. One patient reported loss of elbow flexion preventing thigh lift for transfers. This was resolved with a program of rehabilitation and specific muscle strengthening Conclusions: Zancolli's modified technique is simple and effective, with few complications, whereby we can provide more autonomy for the tetraplegic patient.

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Injured metamere and functional surgery of the tetraplegic upper limb

Cited by 63 publications

References 20 publications

Upper limb surgery for tetraplegia: Assessment of a 10-point strategy

Upper limb surgery for tetraplegia: Assessment of a 10-point strategy

How do C6/C7 tetraplegic patients grasp balls of different sizes and weights? Impact of surgical musculo-tendinous transfers

Biceps to Triceps Transfer in Tetraplegic Patients

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