Tetraplegia-Restoration of strong grasp and lateral pinch in tetraplegia: A comparison of two methods of thumb control in each patient

Restoration of strong grasp and lateral pinch in tetraplegia: A comparison of two methods of thumb control in each patient

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This study compares two methods of thumb control for the restoration of grasp and lateral pinch in tetraplegia patients. The first method involves tendon transfer for thumb adduction-opposition, while the second method involves prepositioning the thumb by arthrodesis of the first metacarpal-trapezial joint. Six patients with spinal cord injuries were selected for the study, and follow-up examinations were conducted 2 to 6 years after surgery. The results showed that hands with the tendon transfer had slightly stronger lateral pinch but weaker grasp compared to hands with the arthrodesis. However, the patients did not have a consistent preference for either method as they were pleased that their hands had been reconstructed differently, allowing for specialization in certain activities. The study also discusses different classifications of tetraplegia and the potential for surgical reconstruction based on the level of spinal cord injury and remaining muscle and sensory function. The paper includes case reports of selected patients who underwent the surgical reconstructions and highlights their improved hand function and satisfaction with the results. The study concludes that both methods of thumb control are effective in restoring grasp and pinch in tetraplegia patients, and the choice of method can be based on individual patient characteristics and preferences.

Keywords

thumb control

restoration

grasp

lateral pinch

tetraplegia patients

tendon transfer

arthrodesis

spinal cord injuries

hand function

surgical reconstruction