Upper extremity reconstruction in non-traumatic spinal cord injuries: An under-recognized opportunity
Jan Fridén, Carina Reinholdt, Johanna Wangdell, Andreas Gohritz
Department of Hand Surgery, Institute of Clinical Sciences, The Sahlgrenska Academy at Göteborg University, 413 45 Göteborg, Sweden. E-mail: firstname.lastname@example.org
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.
Design: Case series. Tests were conducted preoperatively and 12 months postoperatively.
Patients: 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.
Conclusion: 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.
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