Rebalancing the tetraplegic wrist using extensor carpi ulnaris-tenodesis

Patients with cervical spinal cord injury and tetraplegia often present with a radial deviation deformity of the wrist owing to impaired active wrist flexion and extension. Tenodesis of the extensor carpi ulnaris can help optimize grip strength. The purpose of the study was to compare reconstruction of the grip with and without extensor carpi ulnaris-tenodesis, as well as evaluating the outcome of the procedure. The grip strength of the group with tenodesis of the extensor carpi ulnaris was twice as strong as of the group without the tenodesis and with similar wrist joint flexion-extension range of motion. Correction of the wrist deformity enables a more ergonomic use of the hand. This may also help prevent shoulder pain, which is common among patients with tetraplegia.