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Revista Cubana de Ortopedia y Traumatología

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2019, Number 2

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Revista Cubana de Ortopedia y Traumatología 2019; 33 (2)

Reconstructive surgery of the upper limb tetraplegi hand

Bernal GMJ, Cabrera VNJ, Nápoles PM, Álvarez PL
Full text How to cite this article

Language: Spanish
References: 11
Page: 1-14
PDF size: 278.37 Kb.


Key words:

tetraplegic hand, reconstruction, Zancolli technique, House technique, functional surgery.

ABSTRACT

Introduction: In tetraplegic persons, the lack of function of the upper limb constitutes the utmost barrier to their autonomy, which is why many of them consider the reconstruction and recovery of their upper limbs to be very important.
Objective: To describe the restoration of the caliper and the grip of quadriplegic hand with the use of Zancolli and House techniques.
Method: A longitudinal, prospective study was carried out in 12 tetraplegic patients who came to the upper limp consultation at Frank País International Orthopedic Scientific Complex, from January 2013 to December 2016. The study variables were age, sex, injury etiology, classification (according to Giens international classification), dependence on daily activities (Barthel index), function of the limb (Mowery functional classification), personal satisfaction (Allien and Machle scale) and complications. Zancolli and House techniques were used. The information was collected from the medical records of the admitted patients. Data was processed in a microcomputer database with Word and Excel systems. The SPSS 17 statistical system was also used.
Results: Eleven men and one woman (24 hands in total) were treated from the total of patients in the sample. The average age was 30 years, with 8.6 years of latency period. Traumatic spinal cord injury was collected as the etiology of the spinal cord injury.
According to the international Giens classification, there were ten patients in group 4, and two patients in group 5. Complications occurred in three cases. With surgery, all patients were able to change from dependent to independent status. Regarding hand function, the vast majority of the sample was classified as excellent, and regarding personal satisfaction, nine patients reported feeling excellent.
Conclusions: Zancolli and House techniques favor the restoration of the caliper and the grip of the quadriplegic hand, improve joint mobility, muscle strength and the functionality of the hand. These procedures favor the autonomy of the patient and have a high degree of satisfaction.


REFERENCES

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  2. Mohammed KD, Rothwell AG, Sinclair SW, Willem SM, Bean AR. Upper-limb surgery for tetraplegia. J Bone Joint Surg Br. 1992;74:873-9.

  3. Zancolli E. history of surgery in the rehabilitation of the tetraplegi upper limb. Hand clinic. 2002;18:369-76.

  4. Mauck B. M. Paralytic hand. En: Azar FM, Beaty JH, Terry Canale S, editores. Campbell´s Cirugía Ortopédica. 13era ed. Philadelphia: Elsevier, Inc; 2017. p. 3595-637.

  5. Bryden AM, Peljovich AE, Hoyen HA. Surgicl restoration of arm and hand function in people with tetraplegia. Top Spinal Cord Inj Rehabil. 2012;18(1):43-9.

  6. Calandruccio JH, Jobe MT. Mano Paralítica. En: Terry Canale S, Beaty JH, editores. Campbell Cirugía Ortopédica 3. 11na ed. Barcelona: Elsevier España SL; 2013. p. 3621-34.

  7. Moberg E. The upper limb in tetraplegia. Máster de mano. Washington DC: Lippincontt-Roven. Publisher; 1999.

  8. Friden J. Tetraplegia management update. J Hand Surg Am. 2015;40(12):2489-500.

  9. Conolly SJ, Aubut JK, Jarus T. Enhancing upper extremity funtion with reconstructive surgery in person with tetraplegia. Top Spinal Cord Inj Rehabil. 2017;13(1):269-76.

  10. Fattal C, Coulet B, Rouays-Mabit H. Cirugía del miembro superior en la persona tetrapléjica: procedimientos quirúrgicos y programa de rehabilitación. EMC Kinesioterapia y Medicina Física. 2012;33(4):1-17.

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Revista Cubana de Ortopedia y Traumatología. 2019;33