Hand function of C6 and C7 tetraplegics 1 - 16 years following injury.
METHODS
Retrospective cohort study.


OBJECTIVE
To quantify the hand function of C6 and C7 tetraplegics 1 - 16 years after injury.


METHODS
Patients were assessed in their homes.


METHODS
Medical records of patients admitted to the Prince Henry Hospital Spinal Injuries Unit between 1984 and 1999 were used to identify all patients with C6 or C7 tetraplegia at 3 months post injury. Sixty-five patients (107 hands) were identified in this way. Forty-seven patients (81 hands) were located and agreed to partake in the study, and seven (nine hands) had died. Thus 81% of patients (83% of hands) still alive at follow-up were assessed.


METHODS
Unilateral hand function was assessed with the Grasp and Release Test (GRT) and a 10 item Activities of Daily Living (ADL) Test. Prevalance and severity of contractures, lateral grasp (key grip) strength and extensibility of the extrinsic finger flexor muscles were also determined.


RESULTS
All hands except one had been managed without surgical intervention. The median number of ADL tasks successfully completed was 9/10 (interquartile range=8 - 10) and the median number of objects successfully manipulated in the GRT was 3/6 (IQ range=3 - 5). Lateral grasp was poor (74% and 75% of hands could not use a lateral grasp to move the paperweight or depress the fork in the GRT, respectively), and the prevalence of contractures was low (53% of hands had full passive range of motion).


CONCLUSIONS
In the long term, most C6 and C7 tetraplegics attain a high level of hand function despite poor lateral grasps.
Harvey
L A
LA
School of Physiotherapy, University of Sydney, Australia.
Batty
J
J
Jones
R
R
Crosbie
J
J
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D005384:Finger Joint / Q000503:physiopathology*; D005500:Follow-Up Studies; D018737:Hand Strength; D006801:Humans; D015601:Injury Severity Score; D016916:Joint Deformities, Acquired / Q000175:diagnosis / Q000209:etiology / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D011782:Quadriplegia / Q000175:diagnosis / Q000534:rehabilitation*; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D018570:Risk Assessment; D013119:Spinal Cord Injuries / Q000150:complications / Q000175:diagnosis / Q000534:rehabilitation* / Q000601:surgery; D013997:Time Factors