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Management of Upper Extremities in Tetraplegia: Current Concepts

Bednar, Michael S., MD; Woodside, Julie C., MD

JAAOS - Journal of the American Academy of Orthopaedic Surgeons: August 15, 2018 - Volume 26 - Issue 16 - p e333–e341
doi: 10.5435/JAAOS-D-15-00465
Review Article

Individuals with tetraplegia face many obstacles with activities of daily living. Although approximately 65% to 75% of individuals with tetraplegia would benefit from upper extremity surgery that could make many of their activities of daily living more spontaneous, only 14% of patients who are surgical candidates undergo tendon transfer procedures. A good surgical candidate has an injury at one of the cervical spine levels and an International Classification for Surgery of the Hand in Tetraplegia group of 1 or better, has functional goals, and is committed to the postoperative rehabilitation process. Surgery primarily consists of tendon transfers, tenodesis, and arthrodesis to restore elbow extension and hand pinch, grasp, and release. Nerve transfers and functional electrical stimulation are also options for treatment.

From the Department of Orthopaedic Surgery and Rehabilitation, Loyola University Chicago Medical Center, Maywood, IL (Dr. Bednar), and OrthoCarolina, Charlotte, NC (Dr. Woodside).

Neither of the following authors nor any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Bednar and Dr. Woodside.

© 2018 by American Academy of Orthopaedic Surgeons
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