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Upper limb surgery for tetraplegia: a 10-year re-review of hand function
Alastair G Rothwell1, K Anne Sinnott, Khalid D Mohammed
1Burwood Spinal Unit, Christchurch, New Zealand.
Purpose:
To perform a 10-year re-review of hand function outcome for 24 tetraplegic persons who had received bilateral tendon transfers and tenodeses.
Methods:
The Lamb and Chan questionnaire with additional questions, the Quadriplegic Index of Function (QIF), the Swanson sphygmomanometer technique for hook grip, the Preston Pinch Meter (PP) for key pinch, and a digital analyzer (DA) for both hook and key pinch were the test instruments used. The QIF and DA had not been used previously.
Results:
Levels of functional independence and expectations were maintained. Mean hook grip values were maintained for the right hand but increased significantly for the left to reach right hand values. Mean pinch grip values decreased significantly. DA measurements confirmed similar hook grip values for both hands but key pinch values were significantly higher than the PP values. Active transfers averaged approximately twice the strength of tenodeses.
Conclusions:
Hand function improvements gained from tendon transfers and tenodeses are maintained over time.