title: Strategy for improving hand opening in the tetraplegic upper limb.
abstract: In the tetraplegic patient, restoring an adequate grip requires primary restoration of proper hand opening. This opening (or "extensor") surgical stage is performed 3 or 4 months before the closing (or "flexor") stage. Surgical strategy is based on group 5 of the IC, which represents a turning point. Above this group (i.e., in IC groups 2-4), opening is essentially based on passive procedures (such as tenodesis and arthrodesis). Starting at group 5, restoration of active digital extension is [table: see text] feasible, as well as active stabilization of the thumb ray in lower groups. In those lower groups, all efforts should aim at re-establishing an intrinsic balance, keeping in mind the difference between supple and rigid claw deformities, which require different corrective procedures (Table 1).
authors.affiliation: Centre de la Main et du Membre Supérieur, 15 Av du Pr. Grasset, 34 Montpellier, France. teissier.lacaze@wanadoo.fr
authors.forename: Jacques
authors.initials: J
authors.lastname: Teissier
authors.forename: Charles
authors.initials: C
authors.lastname: Fattal
authors.forename: Guy
authors.initials: G
authors.lastname: Egon
mesh_terms: D005385:Fingers / Q000503:physiopathology / Q000601:surgery; D006225:Hand / Q000503:physiopathology / Q000601:surgery*; D018737:Hand Strength; D006801:Humans; D011782:Quadriplegia / Q000503:physiopathology / Q000601:surgery*; D013709:Tendon Transfer; D013933:Thumb / Q000601:surgery