Advertisement

Surgery to restore hand, elbow use underused by quadriplegics

Two-thirds to three-quarters of quadriplegics are eligible for the surgery, but most have no idea the procedure is possible and effective.

By Stephen Feller

MAYWOOD, Idaho, Aug. 24 (UPI) -- Limited function of the hands and elbows of quadriplegics can be restored surgically, but most patients don't undergo the procedure because of a lack of awareness, say researchers.

Tendon transfers can restore function that tops the wishlist three-quarters of patients want the most, but a doctor at Loyola University says a lack of communication among specialists and awareness among patients has prevented the procedure from being performed more often.

Advertisement

There are about 12,500 new spinal cord injuries each year, and 276,000 people living with the injuries. For patients who lose function of their arms or hands, the potential to regain the ability to pinch or grip while moving their arm can restore independence and some semblance of normal daily living.

While 65 percent to 75 percent of cervical spinal cord patients would benefit from tendon transfer to restore some function, only about 14 percent -- or 400 patients -- have them each year.

"A variety of reasons have been proposed to explain why so few patients have surgery, including a lack of communication among rehabilitation specialists, physiatrists, and surgeons, poor access to care, and poor knowledge that such procedures are possible," Dr. Michael Bednar, a hand surgeon at Loyola University, wrote in a study published in the journal Hand Clinics.

Advertisement

Skeletal muscles come in pairs, one to move a bone in one direction and one to move it in the other direction, and are connected to bones by tendons. For muscles that perform the same function, doctors can take the tendon of a "spare" muscle and move it to a nonworking muscle that, with rehabilitation, regains some function.

Although tendon transfers do not restore full function, they allow for increased pinch and grasp strength at levels that allow patients to perform most daily activities.

Bednar writes in the study that more patients would likely undergo the procedure if they were aware of it, based on a previous study showing 75 percent of quadriplegics would want hand function restored before any other. Bowel and bladder use, walking and sexual performance also are strongly desired but less than one in five patients said they would most want them back.

"Although the long-term outcomes of these procedures are good, few patients eligible for these procedures actually have them performed," Bednar wrote.

Latest Headlines