Abstract
Reconstructive upper extremity surgeries in tetraplegia are technically challenging because of the many complicated real-time decisions that need to be made, e.g. extent of release of donor muscle-tendon complex, routing of donor muscles, tissue preparation and optimization, tensioning of muscle-tendon units, balancing joints and suturing tendon-to-tendon attachments. Nerve transfer surgeries can add functionality but also make the reconstruction planning more complex. In this overview, we present some of the fundamental muscle-tendon-joint mechanics studies that allow for single-stage surgical reconstruction of hand function as well as early postoperative activity-based training in patients with cervical spinal cord injuries. We foresee an increased need for studies addressing combined nerve and tendon transfer reconstructions in parallel with patient-perceived outcome investigations. These should be combined with implementation of assistive technology such as functional electrical stimulation for diagnostic, prognostic and training purposes.
Original language | English (US) |
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Pages (from-to) | 343-353 |
Number of pages | 11 |
Journal | Journal of Hand Surgery: European Volume |
Volume | 44 |
Issue number | 4 |
DOIs | |
State | Published - May 1 2019 |
Keywords
- Spinal cord injury
- muscle-tendon-joint mechanics
- outcomes
- single-stage operation
- tetraplegia
- upper limb reconstructive surgery
ASJC Scopus subject areas
- Surgery