Short-term versus long-term comparative results after reconstructive upper-limb surgery in tetraplegic patients.

Abstract

To investigate long-term results after reconstructive upper-limb surgery in tetraplegia and to compare those with short-term results. Six tetraplegic patients (11 deltoid-to-triceps, 10 key-pinch procedures) were evaluated at means of 3 years and 24 years after surgery by the same author using the same methods. All were men, and the mean age at the follow-up evaluations was 53 years. In addition, 5 men (9 deltoid-to-triceps, 6 key-pinch procedures) with a mean age at follow-up evaluation of 55 years completed the questionnaire. All had level C5 to C6 injury and International Classification of 1 or 2 without any active finger movements or elbow extension. At follow-up evaluation, key pinch averaged 1.1 kg, and elbow extension averaged 2.1 kg. After a mean of 21 years, key pinch had deteriorated by 21% and elbow extension by 16%. All patients considered the surgery important. Three of the surviving subjects, all evaluated, were still working regularly. Upper-limb surgery provides permanent beneficial results in patients with tetraplegia. The need for key-pinch and deltoid-to-triceps procedures should be evaluated in all of these patients.