Clinical Presentation
This study highlights the need for comprehensive surgical reconstruction to improve activities of daily living in individuals with limited hand mobility due to C6 tetraplegia [PMID:22105635].
The case studies presented in [PMID:14989333] illustrate the clinical presentation of tetraplegia characterized by impaired handgrip, emphasizing the need for interventions like tendon transfers to restore function.
Management
The alphabet procedure, comprising seven specific tendon transfers and reconstructions, reliably provides grip, grasp, and release function [PMID:22105635].
Participants showed positive satisfaction levels in 73.5% of responses, with nearly 81% reporting improved functional ability post-surgery [PMID:21445079].
In this study, [PMID:14989333] demonstrates successful reconstruction of functional handgrip through surgical tendon transfers, highlighting improvements in both thumb and finger movements in tetraplegic patients.
Prognosis & Follow-up
The authors emphasize that early active training following the extensive alphabet procedure is crucial for facilitating muscle relearning and minimizing post-surgical complications [PMID:22105635].
A significant positive correlation was found between willingness to repeat surgeries and improvements in activities and occupation, with correlation coefficients ranging from 0.53 to 0.63 [PMID:21445079].
The authors of [PMID:14989333] indicate that surgical tendon transfer procedures lead to notable improvements in patients' quality of life by creating functional units in previously plegic hands, suggesting positive long-term outcomes.
Special Populations
Approximately 65% were willing to repeat elbow extension surgeries, while 77.1% were willing to repeat hand/wrist surgeries, indicating differences in patient preferences [PMID:21445079].
References
1 Fridén J, Reinholdt C, Turcsányii I, Gohritz A. A single-stage operation for reconstruction of hand flexion, extension, and intrinsic function in tetraplegia: the alphabet procedure. Techniques in hand & upper extremity surgery 2011. link 2 Jaspers Focks-Feenstra JH, Snoek GJ, Bongers-Janssen HM, Nene AV. Long-term patient satisfaction after reconstructive upper extremity surgery to improve arm-hand function in tetraplegia. Spinal cord 2011. link 3 Cizmár I, Wendsche P, Brychta P, Visna P, Kocis J, Mensík I. Reconstruction of functional handgrip in traumatic tetraplegia--case study. Acta chirurgiae plasticae 2003. link