The Outcome of Tendon Transfers for C6-Spared Quadriplegics

Abstract

The purpose of this study was to review retrospectively and evaluate a uniform group of C6-spared quadriplegics who had similar surgical procedures. Eight patients undergoing 12 procedures were reviewed at an average of 3.8 years follow-up. There were three bilateral procedures. All patients had extensor carpi radialis longus to flexor digitorum profundus and brachioradialis to flexor pollicis longus transfers to improve grip strength and key pinch. All patients reported subjective improvements in quality of life, activities of daily living and patient-centred goals. There were six excellent and two good results. Objective improvements included mild improvements in key pinch and grip strength.

Long-term patient satisfaction after reconstructive upper extremity surgery to improve arm–hand function in tetraplegia

“…Some studies report about satisfaction of participants as well, however, this is usually evaluated using only a few, untested questions. [11][12][13] These studies report that the majority of the participants are satisfied with the results of the surgery. Lo et al 12 described the outcome of tendon transfers for eight C6-spared quadriplegics (12 hands 15 The results of their study showed that 87.5% of their population were satisfied with the operation, 42.8% of the participants felt that the operation had fulfilled their expectations, however, 57.2% expected better results.…”

Variability in Surgical Technique for Brachioradialis Tendon Transfer<sbt aid="1121202">Evidence and Implications</sbt>

“…The brachioradialis is the donor muscle most commonly used for this purpose 1 . Functional outcomes of transfers of the distal tendon of the brachioradialis to the proximal portion of the distal tendon of the flexor pollicis longus to restore lateral pinch function to quadriplegic patients have ranged from excellent to poor [2][3][4][5][6] . Quantitative assessments of pinch force have been reported to vary as much as tenfold among subjects with these transfers [6][7][8][9] .…”

Erratum

“…The brachioradialis tendon has been transferred to the flexor pollicis longus tendon for thumb flexion. There was great experience in this transfer with good results in quadriplegia and lower brachial plexus injuries to restore useful lateral pinch 2, 19, 20. But the excursion of this muscle is limited and can only be used for one function 19…”