Tendon transfer for the restoration of upper limb function after a cervical spinal cord injury

During the past 22 years, 68 patients with cervical spinal cord injuries had 142 tendon transfers and tenodeses. The procedures were performed to provide improved upper limb control, including elbow extension, finger grasp, and thumb pinch for better prehension. The operations were effective in increasing function in all but four patients, who did not improve because of insufficient muscle strength. The educational, vocational, recreational, and social aspects of life improved for many patients. Tendon surgery should be considered for all tetraplegics 1 year after injury, provided that they have undergone an effective rehabilitation program and that their neurologic examination is stable.