Ida K Fox1, Christine B Novak2, Lorna C Kahn3, Susan E Mackinnon1, Rimma Ruvinskaya4, Neringa Juknis4. 1. 1Division of Plastic & Reconstructive Surgery, Washington University School of Medicine, St. Louis, MO USA. 2. 2Division of Plastic & Reconstructive Surgery, University of Toronto, Toronto, ON Canada. 3. 3Milliken Hand Rehabilitation Center, Washington University School of Medicine, St. Louis, MO USA. 4. 4Department of Neurology, Washington University School of Medicine, St. Louis, MO USA.
Abstract
INTRODUCTION: Nerve transfers are used routinely for reconstruction of hand function following lower motor neuron lesions. In people with cervical spinal cord injury (SCI), this novel and alternate reconstruction option may be useful to restore prehension and grasp, and improve hand function. CASE PRESENTATION: A 34-year-old male presented 12 years post-mid-cervical SCI. Pre-operative electrodiagnostic studies revealed intact lower motor neurons below the SCI level. He elected to undergo nerve transfer surgery to restore hand function. Intraoperative evaluation led to the transfer of a brachialis nerve to several median nerve recipient branches. Post surgery, he was discharged home and resumed activities of daily living. He achieved independent thumb and finger flexion function and continued to exhibit functional improvement at 4 years post surgery. DISCUSSION: These results should prompt referral for consideration of nerve transfer surgery-an exciting alternative to tendon transfer and neuroprostheses.
INTRODUCTION: Nerve transfers are used routinely for reconstruction of hand function following lower motor neuron lesions. In people with cervical spinal cord injury (SCI), this novel and alternate reconstruction option may be useful to restore prehension and grasp, and improve hand function. CASE PRESENTATION: A 34-year-old male presented 12 years post-mid-cervical SCI. Pre-operative electrodiagnostic studies revealed intact lower motor neurons below the SCI level. He elected to undergo nerve transfer surgery to restore hand function. Intraoperative evaluation led to the transfer of a brachialis nerve to several median nerve recipient branches. Post surgery, he was discharged home and resumed activities of daily living. He achieved independent thumb and finger flexion function and continued to exhibit functional improvement at 4 years post surgery. DISCUSSION: These results should prompt referral for consideration of nerve transfer surgery-an exciting alternative to tendon transfer and neuroprostheses.
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