Short-term versus long-term comparative results after reconstructive upper-limb surgery in tetraplegic patients.
OBJECTIVE
To investigate long-term results after reconstructive upper-limb surgery in tetraplegia and to compare those with short-term results.


METHODS
Six tetraplegic patients (11 deltoid-to-triceps, 10 key-pinch procedures) were evaluated at means of 3 years and 24 years after surgery by the same author using the same methods. All were men, and the mean age at the follow-up evaluations was 53 years. In addition, 5 men (9 deltoid-to-triceps, 6 key-pinch procedures) with a mean age at follow-up evaluation of 55 years completed the questionnaire. All had level C5 to C6 injury and International Classification of 1 or 2 without any active finger movements or elbow extension.


RESULTS
At follow-up evaluation, key pinch averaged 1.1 kg, and elbow extension averaged 2.1 kg. After a mean of 21 years, key pinch had deteriorated by 21% and elbow extension by 16%. All patients considered the surgery important. Three of the surviving subjects, all evaluated, were still working regularly.


CONCLUSIONS
Upper-limb surgery provides permanent beneficial results in patients with tetraplegia. The need for key-pinch and deltoid-to-triceps procedures should be evaluated in all of these patients.
Vastamäki
Martti
M
ORTON Hospital, Invalid Foundation, Helsinki, Finland. martti.vastamaki@invalidisaatio.fi <martti.vastamaki@invalidisaatio.fi>
D000203:Activities of Daily Living; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D052581:Pinch Strength / Q000502:physiology; D011782:Quadriplegia / Q000503:physiopathology / Q000601:surgery*; D016059:Range of Motion, Articular / Q000502:physiology; D011795:Surveys and Questionnaires; D013709:Tendon Transfer; D013710:Tendons / Q000637:transplantation*; D016896:Treatment Outcome; D034941:Upper Extremity / Q000503:physiopathology / Q000601:surgery*