Upper-Extremity Reconstruction in Tetraplegia: A Critical Analysis Review.

JBJS Rev · Jul 2020 · Review

Cantwell SR, Rhee PC

1Division of Plastic Surgery, Department of Surgery (S.R.C.), and Division of Hand Surgery, Minnesota

Hand & Upper Extremity

SUMMARY — THE REDUCTIONPeripheral nerve transfers expand surgical options for tetraplegic upper-extremity reconstruction by enabling alternative donor sources beyond traditional tendon transfers.
Abstract, as published

Management of tetraplegia should be individualized to a patient's particular deficiencies and functional goals. Surgical decision-making for upper-extremity reconstruction in patients with tetraplegia relies on a thorough physical examination to determine which nerves and muscles remain under volitional control with adequate strength for transfer. Peripheral nerve transfers, either in conjunction with or in place of traditional tendon transfers, enable providers to offer an expanded set of surgical options for patients with tetraplegia who are seeking upper-extremity reconstruction. All upper-extremity reconstructive efforts should be carefully considered with regard to their potential effects on the availability of future reconstructive efforts.

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