An injury affecting the spinal cord at the cervical level leads to paralysis of the upper extremities. In other words, the hand, wrist, elbow and shoulder may be weakened, and this limitation is more severe the higher the level of the lesion. The hand can lose all its expressiveness and touch in a lesion of these dimensions.
In the case of the quadriplegic patient, his very limited hand mobility does not allow him to perform daily activities of daily living without the help of a third person. Hand surgery offers the quadriplegic patient a new opportunity to carry out actions that were previously impossible. It gives him greater independence, such as being able to leave the electric wheelchair and take the manual one to move the wheels with his own hands and strength. Independence also enters the field of the home, since they can clean themselves, dress themselves, eat on their own, etc.
All quadriplegics with active elbow flexion, or those with lesions with controlled spasticity and no stiffness in the hands, can benefit from this palliative surgery. In addition, it is essential that the patient accepts his or her neurological injury and that he or she is cooperative. The collaboration of the family is also essential, because once the patient has undergone the operation and during the rehabilitation period, his or her mobility is considerably reduced.
How is it done?
The surgery used will depend on the level of neurological involvement of the injury. The main objectives are elbow extension, finger flexion-extension and thumb flexion-opposition. In elbow extension, the time the elbow should remain immobilized is four weeks. In oppositional thumb flexion, on the other hand, the rehabilitation time increases to almost one year.