title: Rehabilitation of Supinator Nerve to Posterior Interosseous Nerve Transfer in Individuals With Tetraplegia.
abstract: Despite being a routine part of the early surgical management of brachial plexus injury, nerve transfers have only recently been used as a reconstructive option for those with tetraplegia. Subsequently, there is limited published literature on the rehabilitation theories and techniques for optimizing outcomes in this population. This article seeks to address this void by presenting our centers' working model for rehabilitation after nerve transfers for individuals with tetraplegia. The model is illustrated with the example of the rehabilitation process after a supinator nerve to posterior interosseous nerve transfer. This nerve transfer reconstructs wrist, finger, and thumb extension. The topics covered in the model include the following: patient selection and presurgical planning/intervention, managing the postoperative healing phase of an individual who is wheelchair dependent, maximizing motor reeducation, increasing muscle strength, and ensuring use in functional tasks. This article provides a platform for further development and collaboration to improve the outcomes of patients who undergo nerve transfers after tetraplegia.
authors.affiliation: Victorian Spinal Cord Service, Austin Health, Kew, VIC, Australia. Electronic address: Upper.limb.program@austin.org.au.
authors.forename: Jodie
authors.initials: J
authors.lastname: Hahn
authors.affiliation: Victorian Spinal Cord Service, Austin Health, Kew, VIC, Australia.
authors.forename: Catherine
authors.initials: C
authors.lastname: Cooper
authors.affiliation: Department of Plastic and Reconstructive Surgery, Austin Health, Heidelberg, VIC, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Flood
authors.affiliation: Department of Plastic and Reconstructive Surgery, Austin Health, Heidelberg, VIC, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Weymouth
authors.affiliation: Department of Plastic and Reconstructive Surgery, Austin Health, Heidelberg, VIC, Australia.
authors.forename: Natasha
authors.initials: N
authors.lastname: van Zyl
mesh_terms: D005385:Fingers / Q000502:physiology; D006801:Humans; D053580:Muscle Strength; D018482:Muscle, Skeletal; D016067:Nerve Transfer / Q000379:methods / Q000534:rehabilitation*; D018579:Patient Selection; D026741:Physical Therapy Modalities; D011782:Quadriplegia / Q000209:etiology / Q000534:rehabilitation* / Q000601:surgery*; D013119:Spinal Cord Injuries / Q000150:complications; D013997:Time Factors; D034941:Upper Extremity / Q000503:physiopathology / Q000601:surgery*; D014953:Wrist / Q000502:physiology
keywords: Nerve transfer; Quadriplegia; Rehabilitation; Supination; Upper extremity