title: Upper extremity reconstruction in non-traumatic spinal cord injuries: An under-recognized opportunity.
abstract: OBJECTIVE
  This study reviews the usefulness of surgical improvement of arm and hand function in patients with non-traumatic spinal cord injury who differ significantly from individuals with post-traumatic tetraplegia with respect to age, injury pattern, gender and socio-economic factors.
  
  
  METHODS
  Case series. Tests were conducted preoperatively and 12 months postoperatively.
  
  
  METHODS
  The results of 14 upper extremity reconstructions in 11 patients (7 women, 4 men) with spinal cord injury, mean age at injury 49 years (standard deviation (SD) 12), were reviewed.
  
  
  METHODS
  Key pinch strength, grip strength and first web space opening were recorded pre- and post-operatively in all patients, 5 patients (7 hands) were evaluated prospectively regarding manual dexterity.
  
  
  RESULTS
  All parameters were significantly improved. Strength of key pinch increased from 0.3 kg in 1 case and zero in 10 cases to a mean of 1.6 kg (SD 0.9). Mean grip strength increased from 0 to 3.2 kg (SD 4.5). Maximal distance between thumb and index increased from 2.1 cm (SD 4.1) to 6.4 cm (SD 4.4). Manual dexterity increased.
  
  
  CONCLUSIONS
  Individuals with stable non-traumatic tetraplegia benefit from surgical rehabilitation of their upper extremities. The number of non-traumatic spinal cord injuries is likely to increase as lifespan increases worldwide, and further research into the functional rehabilitation of this population will therefore become increasingly relevant.
authors.affiliation: Department of Hand Surgery, Institute of Clinical Sciences, The Sahlgrenska Academy at Göteborg University, 413 45 Göteborg, Sweden. jan.friden@orthop.gu.se.
authors.forename: Jan
authors.initials: J
authors.lastname: Fridén
authors.forename: Carina
authors.initials: C
authors.lastname: Reinholdt
authors.forename: Johanna
authors.initials: J
authors.lastname: Wangdell
authors.forename: Andreas
authors.initials: A
authors.lastname: Gohritz
mesh_terms: D000328:Adult; D005260:Female; D018737:Hand Strength; D006801:Humans; D007593:Joint Instability / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011782:Quadriplegia / Q000209:etiology / Q000534:rehabilitation* / Q000601:surgery*; D019651:Plastic Surgery Procedures; D013119:Spinal Cord Injuries / Q000150:complications / Q000534:rehabilitation*; D013709:Tendon Transfer; D034941:Upper Extremity / Q000601:surgery*