Management of Upper Extremities in Tetraplegia: Current Concepts
Individuals with tetraplegia face many obstacles with activities of daily living. Although approximately 65% to 75% of individuals with tetraplegia would benefit from upper extremity surgery that could make many of their activities of daily living more spontaneous, only 14% of patients who are surgi...
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Veröffentlicht in: | Journal of the American Academy of Orthopaedic Surgeons 2018-08, Vol.26 (16), p.e333-e341 |
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creator | Bednar, Michael S. Woodside, Julie C. |
description | Individuals with tetraplegia face many obstacles with activities of daily living. Although approximately 65% to 75% of individuals with tetraplegia would benefit from upper extremity surgery that could make many of their activities of daily living more spontaneous, only 14% of patients who are surgical candidates undergo tendon transfer procedures. A good surgical candidate has an injury at one of the cervical spine levels and an International Classification for Surgery of the Hand in Tetraplegia group of 1 or better, has functional goals, and is committed to the postoperative rehabilitation process. Surgery primarily consists of tendon transfers, tenodesis, and arthrodesis to restore elbow extension and hand pinch, grasp, and release. Nerve transfers and functional electrical stimulation are also options for treatment. |
doi_str_mv | 10.5435/JAAOS-D-15-00465 |
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Although approximately 65% to 75% of individuals with tetraplegia would benefit from upper extremity surgery that could make many of their activities of daily living more spontaneous, only 14% of patients who are surgical candidates undergo tendon transfer procedures. A good surgical candidate has an injury at one of the cervical spine levels and an International Classification for Surgery of the Hand in Tetraplegia group of 1 or better, has functional goals, and is committed to the postoperative rehabilitation process. Surgery primarily consists of tendon transfers, tenodesis, and arthrodesis to restore elbow extension and hand pinch, grasp, and release. 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Nerve transfers and functional electrical stimulation are also options for treatment.</description><subject>Activities of Daily Living</subject><subject>Arthrodesis - methods</subject><subject>Hand - surgery</subject><subject>Humans</subject><subject>Quadriplegia - physiopathology</subject><subject>Quadriplegia - surgery</subject><subject>Tendon Transfer - methods</subject><subject>Tenodesis - methods</subject><subject>Upper Extremity - physiopathology</subject><subject>Upper Extremity - surgery</subject><issn>1067-151X</issn><issn>1940-5480</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkTlPAzEQRi0E4u6p0JY0C-MzGyqiJFwCpSBIdJbXOwkLe2HvKvDvcRJAUFF5JL_v0-gNIUcUTqXg8ux2MJg8xKOYyhhAKLlBdmlfQCxFApthBtULf_Rph-x5_wJAlVD9bbLDAZgQjO6Si3tTmTmWWLVRPYsemwZdNH5vHZZ5m6OP8iqaYutMU-A8N-fRsHNuCQ_rymLT-gOyNTOFx8Ovd59ML8fT4XV8N7m6GQ7uYiu4krHJZoKJTKaMGRTYM9QalClNILMp9rmilhlGWdgrYVYmPEVkyFUGad8axffJybq2cfVbh77VZe4tFoWpsO68ZtBjNOGUJQGFNWpd7b3DmW5cXhr3oSnopTa90qZHmkq90hYix1_tXVpi9hP49hQAsQYWddGi869Ft0Cnn9EU7fPf3l_n-CcW7sGE4jJmEDwkVEKIAXD-CfWLiGI</recordid><startdate>20180815</startdate><enddate>20180815</enddate><creator>Bednar, Michael S.</creator><creator>Woodside, Julie C.</creator><general>Lippincott Williams & Wilkins</general><general>by American Academy of Orthopaedic Surgeons</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20180815</creationdate><title>Management of Upper Extremities in Tetraplegia: Current Concepts</title><author>Bednar, Michael S. ; Woodside, Julie C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4365-adf424d5b22ae4e7a1cae5b180dcbe9361c2a21202482c583bee2e36d0b9ca63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Activities of Daily Living</topic><topic>Arthrodesis - methods</topic><topic>Hand - surgery</topic><topic>Humans</topic><topic>Quadriplegia - physiopathology</topic><topic>Quadriplegia - surgery</topic><topic>Tendon Transfer - methods</topic><topic>Tenodesis - methods</topic><topic>Upper Extremity - physiopathology</topic><topic>Upper Extremity - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bednar, Michael S.</creatorcontrib><creatorcontrib>Woodside, Julie C.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American Academy of Orthopaedic Surgeons</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bednar, Michael S.</au><au>Woodside, Julie C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Management of Upper Extremities in Tetraplegia: Current Concepts</atitle><jtitle>Journal of the American Academy of Orthopaedic Surgeons</jtitle><addtitle>J Am Acad Orthop Surg</addtitle><date>2018-08-15</date><risdate>2018</risdate><volume>26</volume><issue>16</issue><spage>e333</spage><epage>e341</epage><pages>e333-e341</pages><issn>1067-151X</issn><eissn>1940-5480</eissn><abstract>Individuals with tetraplegia face many obstacles with activities of daily living. 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subjects | Activities of Daily Living Arthrodesis - methods Hand - surgery Humans Quadriplegia - physiopathology Quadriplegia - surgery Tendon Transfer - methods Tenodesis - methods Upper Extremity - physiopathology Upper Extremity - surgery |
title | Management of Upper Extremities in Tetraplegia: Current Concepts |
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