Flexor pollicis longus tenodesis in tetraplegia at the sixth cervical level. A prospective evaluation of functional gain.

Eight patients with tetraplegia at the sixth cervical level had ten flexor pollicis longus tenodeses performed to create a key grip. Two of the patients also had tendon transfers to create active finger flexion; these failed. The remaining six patients were objectively evaluated by the hand-function test of Jebsen et al. to measure gains in hand function. All patients improved postoperatively, the average improvement being 31 per cent. Although these patients did not add many new hand activities to their repertoire, they showed increased speed and ease of pre-existing hand functions. Three patients did gain the ability to self-catheterize, enabling two of them to live totally independent life-styles. Fixation of the thumb interphalangeal joint with Kirschner wires did not provide sufficient long-term stability, and initial arthrodesis of this joint is recommended in conjunction with the flexor pollicis longus tenodesis.