Introduction The thumb is an essential part of the hand and plays a key role in power and precision grip, together with the fingers. The major goals of thumb reconstruction vary from patient to patient, but may include maintenance of…
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Introduction Given the success of nerve transfers for the treatment of brachial plexus and peripheral nerve injuries, many surgeons also use this form of treatment to circumvent the damaged areas of the spinal cord and reestablish essential motor function (…
Indications Performed in patients with intact wrist extension supported by the extensor carpi radialis brevis (ECRB) who require transfer for active finger flexion. Patients must be at least class 3 on the International Classification for Surgery of the Hand in…
Indications In group 1 patients, the brachioradialis (BR) is available for tendon transfer to provide wrist extension. After restoration of wrist extension, tenodesis can create passive lateral key pinch, leading to significant improvement in a patient’s independence and ability to…
Indications Restoration of a strong, stable pinch between the pad of the thumb and the radiolateral aspect of the index finger is critical for spinal cord injury (SCI) patients. This facilitates manipulation of small objects, including pens and utensils for…
Indications After restoration of elbow extension, wrist extension is next on the reconstructive ladder for tetraplegic patients. This procedure is suitable for International Classification of Surgery of the Hand in Tetraplegia Group 1 patients who have available brachioradialis (BR) but…
Indications Restoration of elbow extension is critical for patients with tetraplegia. It enables patients to perform various overhead and manual activities and sets the stage for subsequent reconstruction of the upper extremity. Patients should have a supple elbow joint on…
This chapter gives an overview of the indications, clinical exam, and principles for the surgical treatment of spinal cord patients who desire reconstruction of the upper extremity. The corresponding procedure details are found in Chapter 70, Chapter 71, Chapter 72,…
Indications Any deficits attributable to the median nerve with an associated laceration or injury along the course of the nerve, high-energy injuries associated with blunt trauma and no appreciable median nerve recovery on examination, and prior median nerve repairs with…