Restoration of strong grasp and lateral pinch in tetraplegia: a comparison of two methods of thumb control in each patient.

Six patients with spinal cord injury who ranged in age from 25 to 42 years were selected for surgery that used a tendon transfer for opposition-adduction of one thumb and arthrodesis of the carpometacarpal joint of the other in each patient. At follow-up 2 to 6 years later, the hands with the opponens-adductorplasty had a slightly stronger lateral pinch (3.75 kg versus 3.31 kg), but the hands with the carpometacarpal arthrodesis had a somewhat stronger grasp (7.42 kg versus 6.86 kg). The patients did not exhibit a consistent preference for either method, but rather, were particularly pleased that their hands had been reconstructed differently, thereby allowing each to be somewhat "specialized" for certain activities.