Improvement of urological-management abilities in individuals with tetraplegia by reconstructive hand surgery.
OBJECTIVE
To evaluate whether reconstructive hand surgery could improve the ability of tetraplegic patients to perform clean intermittent self-catheterization (CIC).


METHODS
The subjects were patients with complete traumatic tetraplegia admitted to the Nagano Rehabilitation Center between 1977 and 1996. A total of 63 subjects were included in this study with an age range of 18-73 years (mean 38.2 years). Reconstructive hand surgery was performed on 44 hands (28 cases). Current urological conditions were assessed by interview or mail questionnaire.


RESULTS
Fifty-one per cent (22/43) of the patients with C6 level of tetraplegia and 86% (12/14) of those with C7 or C8 neurological level of injury could perform CIC independently and only one subject needed assisted CIC.


CONCLUSIONS
CIC is the preferred option for people with tetraplegia. Reconstructive hand surgery is thus recommended to make urological management more independent for a selected group of people with tetraplegia.
Kiyono
Y
Y
Department of Orthopaedic Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621 Japan.
Hashizume
C
C
Ohtsuka
K
K
Igawa
Y
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006225:Hand / Q000294:innervation / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011782:Quadriplegia / Q000150:complications* / Q000534:rehabilitation*; D019651:Plastic Surgery Procedures; D012648:Self Care; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D001750:Urinary Bladder, Neurogenic / Q000209:etiology / Q000534:rehabilitation* / Q000628:therapy; D014546:Urinary Catheterization