Tendon transfers as applied to tetraplegia

Revol, M.; Cormerais, A.; Laffont, I.; Pedelucq, J.-P.; Dizien, O; Servant, J.-M.

doi:10.1016/s0749-0712(02)00028-8

Cited by 25 publications

(16 citation statements)

References 20 publications

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“…These functional benefits have been largely demonstrated with different assessment methods, varying from dynamometry to functional evaluation in activities of daily life. 8,10,11,13,30,34 Here, we further analyse the mechanism of this improvement.…”

Section: Importance and Function Of An Active Elbow Extensormentioning

confidence: 95%

“…These results corroborate clinical observations of the functional benefits of surgical restoration of active elbow extension by musculo-tendinous transfer. 8,13,24,30 Current hypotheses concerning the benefit of the presence of an active elbow extensor include the ability to maintain a stable arm posture, especially when the hand is raised above the shoulder level, as is the case in the present task, 31 the ability to interact with a variety of external objects and forces, 32 or the ability to propulse a manual wheelchair. In addition, our results suggest that the presence of a non-paralysed triceps, or of a surgically transferred muscle, facilitates prehension, probably by stabilisation of the elbow during the transport of the objects.…”

Section: Importance and Function Of An Active Elbow Extensormentioning

confidence: 98%

“…For example, restoration of hand opening is usually based on passive procedures (such as tenodesis and arthrodesis) for groups 2-4 in the international classification. 37 According to other authors, 8 the Brachio Radialis can be used as transfer to the EDC, even in patients with paralysis of the Flexor Carpi Radialis (FCR) in groups 2-4. The 'Tetra Ball Test', focusing on the results concerning the diameter of the objects patients have to grasp and release, could answer this question about the utility to use Brachio Radialis to enhance hand opening.…”

Section: Importance and Function Of An Active Elbow Extensormentioning

confidence: 99%

“…[8][9][10] To compensate the paralysis of the triceps, a transfer of the distal anatomical insertion of either the deltoid or the Biceps Brachii onto the triceps tendon is now currently proposed. To restore active grasp and key grip, several surgical procedures are available by transferring redundant non-paralysed muscles of the forearm on fingers flexors or extensors: usual motors of active transfers are Brachio Radialis and Extensor Carpi Radialis Longus.…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Importance and Function Of An Active Elbow Extensormentioning

confidence: 95%

Section: Importance and Function Of An Active Elbow Extensormentioning

confidence: 98%

Section: Importance and Function Of An Active Elbow Extensormentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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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“…8 In contrast, the majority of C8 level patients can perform ISC with active pinch and grasp holds. 9 Hand function can be improved by upper limb reanimation (ULR) protocols consisting of reconstructive surgery 10,11 (tendon transfers, tenodeses and arthrodeses) combined with specific rehabilitation procedures (tasked motor training, biofeedback and new muscle-function integration). 12 These protocols improve hand abilities, activities of daily living (ADL) and quality of life (QoL).…”

Section: Introductionmentioning

confidence: 99%

Self-catheterization acquisition after hand reanimation protocols in C5–C7 tetraplegic patients

et al. 2010

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Study design: Case series from a prospectively acquired database and phone survey. Objectives: To assess the efficacy of upper limb reanimation (ULR) protocols on acquisition of intermittent self-catheterization (ISC) in C5-C7 ASIA tetraplegic patients. Setting: University Hospital, Paris, France. Methods: A prospectively acquired database of 152 tetraplegic patients followed in ULR consultation between 1997 and 2008 in a rehabilitation unit was studied. A total of 20 patients met the inclusion criteria, which mainly were traumatic C5-C7 tetraplegic adult patients who were unable to perform ISC, and who benefited from ULR with the objectives of improving hand abilities and of ISC acquisition, through urethral orifice for males or via a continent urinary stoma for females. The main outcome measure was ISC acquisition (ISC þ ) proportion. Population characteristics and secondary outcome measures: ISC þ /ISCÀ patients were compared regarding epidemiological and surgical data, key-grip strength, patient global improvement score, activities of daily living and quality of life (PGI-I, Wuolle questionnaire, verbal rating scale). Results: ISC þ was 75%. It depended on key-grip strength (Po0.05) and led to a statistically significant improvement of urinary status compared with ISCÀ patients (Po0.01). ULR improved patients' abilities and QoL in both ISC þ and ISCÀ patients. Conclusion: ULR protocols allow ISC in most C5-C7 tetraplegic patients. Multidisciplinary care with surgeons and PRM physicians improves patients' vital and functional prognosis by changing their urological-management method.

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