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

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

doi:10.1016/j.main.2008.04.003

Cited by 5 publications

(2 citation statements)

References 17 publications

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“…14 Finally, although not used in this study, the technique can also be used as salvage surgery after failed deltoid-to-triceps transfer. 13,21 The good results obtained in our series are similar to those reported in other studies. Kuz et al 14 published a series of 4 medial route transfers, achieving M4 elbow extension against resistance in all arms and considerable functional improvement as we have also obtained.…”

Section: Discussionsupporting

confidence: 91%

“…4,21 The medialization of anterior deltoid as described by Johnstone 10 is an available option for shoulder stabilization before the deltoid-to-triceps transfer in high tetraplegia but, in our opinion, this technique adds major risks to surgery as the possible injury to the subclavian vessels and recovery sometimes takes longer. 4 Various complications have been reported with the deltoid-to-biceps transfer, including lack of the final 60° of active extension against gravity in 50% of patients, stretching of the tendon repair resulting in decreased strength and extensor lag, 11,13,19 infection of the graft, 21 and development of heterotopic ossification in the posterior deltoid muscle. 14,18 The biceps-to-triceps transfer was first described by Mayer in 1951 and Friedenberg in 1954, 9 and popularized in tetraplegic patients by Zancolli, 14 by performing the transfer by the medial route.…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionsupporting

confidence: 91%