Current Concepts in Elbow Extension Reconstruction for the Tetraplegic Patient.
Publication/Presentation Date
3-1-2023
Abstract
Individuals with C5 or C6 spinal cord injury (SCI) have paralysis of the triceps brachii, and the subsequent loss of elbow extension makes it impossible to reliably use their hands above shoulder level because of the inability to hold the elbow extended against gravity. For persons with cervical SCI, elbow extension can be restored with both tendon and nerve transfers. Elbow extension is necessary for dressing, eating, wheelchair locomotion, pressure relief maneuvers, independent transfers, and reaching objects above shoulder level. Deltoid-to-triceps and biceps-to-triceps tendon transfers have established efficacy and a longer history of use. Transfer of motor branches from the axillary nerve to triceps motor branches is new with no current published prospective studies but shows early promise. This review aims to highlight the amazing potential these procedures can have on the independence and quality of life for people with quadriplegia. Despite the immense benefit possible, fewer than 14% of eligible people with cervical SCI in the United States receive upper limb reconstructive surgery. Surgical timing is critical. A broader understanding and raised awareness of reconstructive options for elbow extension in people with quadriplegia will increase recognition of eligible patients and speed referral time to the appropriate practitioner.
Volume
31
Issue
5
First Page
221
Last Page
228
ISSN
1940-5480
Published In/Presented At
Zlotolow, D. A., Kripke, L. A., & Kozin, S. H. (2023). Current Concepts in Elbow Extension Reconstruction for the Tetraplegic Patient. The Journal of the American Academy of Orthopaedic Surgeons, 31(5), 221–228. https://doi.org/10.5435/JAAOS-D-22-00348
Disciplines
Medicine and Health Sciences
PubMedID
36745692
Department(s)
Department of Surgery
Document Type
Article