Restoration of strong grasp and lateral pinch in tetraplegia due to cervical spinal cord injury

James H. House, Frank W. Gwathmey, Douglas K. Lundsgaard

Research output: Contribution to journalArticlepeer-review

78 Scopus citations

Abstract

Patients with tetraplegia who have “strong” sixth cervical neurologic (C-6) function often can be given active grasp and strong lateral pinch by tendon transfers and tenodeses. Wrist control can be retained by the extensor carpi radialis brevis and flexor carpi radialis and can permit transfer of the extensor carpi radialis longus to provide finger flexion. Either the brachioradialis or pronator teres then is available for transfer to restore adduction-opposition of the thumb with an in situ tendon graft of a paralyzed flexor superficialis rerouted to the thumb through a palmar fascial pulley. The other motor can provide thumb flexion for strong lateral pinch. Extrinsic and intrinsic extension can be provided by tenodeses. With seventh cervical neurologic (C-7) function retained, active digital extension is present and functional expectations are better. Ten hands in seven patients with traumatic tetraplegia from injuries at C-6 or C-7 level have been reconstructed. The average grasp and pinch force after operation was 5.5 and 3.0 Kg., respectively. All patients but one were pleased with the increased function and improved efficiency.

Original languageEnglish (US)
Pages (from-to)152-159
Number of pages8
JournalJournal of Hand Surgery
Volume1
Issue number2
DOIs
StatePublished - Jan 1 1976

Fingerprint Dive into the research topics of 'Restoration of strong grasp and lateral pinch in tetraplegia due to cervical spinal cord injury'. Together they form a unique fingerprint.

Cite this