Tetraplegia-Case: Tetraplegia

Case: Tetraplegia

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Case 1 describes a 25-year-old male who has a complete spinal cord injury (SCI) at the C5/6 level. He has strong elbow flexion but lacks voluntary extension. He also has strong wrist extension and a supple hand for pinching and grasping. The treatment plan includes a biceps to triceps transfer and a brachioradialis to flexor pollicis longus (FPL) split transfer with carpal metacarpal (CMC) arthrodesis. The key points emphasize the importance of active elbow extension for functional workspace, proper thumb positioning during pinching, and prioritizing lateral pinch for daily activities.<br /><br />Case 2 involves a 35-year-old male with a complete SCI at the C6/7 level. He has strong elbow and wrist flexion and extension, as well as good forearm pronation. He also has a supple hand with reasonable pinching and grasping abilities. The treatment plan for this patient includes powered tendon transfers, nerve transfers, and a transfer of the extensor carpi radialis longus (ECRL) to the flexor digitorum profundus (FDP). Key points for this case highlight the importance of having enough donor muscles for reconstruction, avoiding certain muscle transfers for centralized wrist extension and wheelchair propulsion, and the added benefit of nerve transfers for increasing hand reconstruction capacity.<br /><br />Both cases demonstrate the challenges of tetraplegia and the importance of restoring function and independence in activities of daily living. The treatment plans in both cases involve various surgical transfers and procedures to improve hand function. The key points provide important considerations and principles for successful hand reconstruction in individuals with tetraplegia.

Keywords

spinal cord injury

C5/6 level

elbow flexion

voluntary extension

wrist extension

hand function

tetraplegia

surgical transfers

hand reconstruction

activities of daily living