Dataset Information

Nerve transfers in tetraplegia I: Background and technique.

ABSTRACT:

Background

The recovery of hand function is consistently rated as the highest priority for persons with tetraplegia. Recovering even partial arm and hand function can have an enormous impact on independence and quality of life of an individual. Currently, tendon transfers are the accepted modality for improving hand function. In this procedure, the distal end of a functional muscle is cut and reattached at the insertion site of a nonfunctional muscle. The tendon transfer sacrifices the function at a lesser location to provide function at a more important location. Nerve transfers are conceptually similar to tendon transfers and involve cutting and connecting a healthy but less critical nerve to a more important but paralyzed nerve to restore its function.

Methods

We present a case of a 28-year-old patient with a C5-level ASIA B (international classification level 1) injury who underwent nerve transfers to restore arm and hand function. Intact peripheral innervation was confirmed in the paralyzed muscle groups corresponding to finger flexors and extensors, wrist flexors and extensors, and triceps bilaterally. Volitional control and good strength were present in the biceps and brachialis muscles, the deltoid, and the trapezius. The patient underwent nerve transfers to restore finger flexion and extension, wrist flexion and extension, and elbow extension. Intraoperative motor-evoked potentials and direct nerve stimulation were used to identify donor and recipient nerve branches.

Results

The patient tolerated the procedure well, with a preserved function in both elbow flexion and shoulder abduction.

Conclusions

Nerve transfers are a technically feasible means of restoring the upper extremity function in tetraplegia in cases that may not be amenable to tendon transfers.

SUBMITTER: Brown JM

PROVIDER: S-EPMC3172032 | biostudies-literature | 2011

REPOSITORIES: biostudies-literature

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Publications

Nerve transfers in tetraplegia I: Background and technique.

Brown Justin M JM

Surgical neurology international 20110830

<h4>Background</h4>The recovery of hand function is consistently rated as the highest priority for persons with tetraplegia. Recovering even partial arm and hand function can have an enormous impact on independence and quality of life of an individual. Currently, tendon transfers are the accepted modality for improving hand function. In this procedure, the distal end of a functional muscle is cut and reattached at the insertion site of a nonfunctional muscle. The tendon transfer sacrifices the f ...[more]

PMID: 21918736

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Dataset Information

Nerve transfers in tetraplegia I: Background and technique.

Background

Methods

Results

Conclusions

Publications

Nerve transfers in tetraplegia I: Background and technique.

Similar Datasets

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