Upper Extremity Surgery in Tetraplegia and the Online Information Void

Background: People with tetraplegia lack awareness of, and subsequently underutilize, reconstructive surgery to improve upper extremity function. This is a topic of international discussion. To bridge the information gap, proposed mandates encourage providers to discuss surgical options with all tetraplegic patients. Outside of the clinical setting, little is known about information available to patients and caregivers-particularly online. The purpose of this study is to evaluate online content for surgical options for improved upper extremity function for people with tetraplegia. Methods: A sample of online content was generated using common search engines and 2 categories of key words and phrases, general and specific. Articles on the first 2 search pages were evaluated for content and audience. Results: A total of 76 different search results appeared on the first 2 pages using 8 unique search phrases. Of articles generated from general phrases, only 5% mentioned tendon or nerve transfers in tetraplegia. When more specific key search phrases were used, the number of lay articles increased to 71%. Conclusions: Based on initial results, general online information on the management of tetraplegia largely excludes discussions of upper limb reconstruction and the well-known benefits. Unless patients, their caregivers, and nonsurgical health care providers have baseline knowledge of tendon and/or nerve transfers, they are unlikely to obtain de novo awareness of surgical options with self-initiated searches. Thus, the challenge and opportunity is to revise the online dialogue to include upper extremity surgery as a fundamental tenet of tetraplegia care.