Abstract
Despite being a routine part of the early surgical management of brachial plexus injury,
nerve transfers have only recently been used as a reconstructive option for those
with tetraplegia. Subsequently, there is limited published literature on the rehabilitation
theories and techniques for optimizing outcomes in this population. This article seeks
to address this void by presenting our centers' working model for rehabilitation after
nerve transfers for individuals with tetraplegia. The model is illustrated with the
example of the rehabilitation process after a supinator nerve to posterior interosseous
nerve transfer. This nerve transfer reconstructs wrist, finger, and thumb extension.
The topics covered in the model include the following: patient selection and presurgical
planning/intervention, managing the postoperative healing phase of an individual who
is wheelchair dependent, maximizing motor reeducation, increasing muscle strength,
and ensuring use in functional tasks. This article provides a platform for further
development and collaboration to improve the outcomes of patients who undergo nerve
transfers after tetraplegia.
Keywords
List of abbreviations:
BPI (brachial plexus injury), cSCI (cervical spinal cord injury), EDC (extensor digitorum communis), EPL (extensor pollicis longus), IPJ (interphalangeal joint), MCPJ (metacarpophalangeal joint), MRC (Medical Research Council), PIN (posterior interosseous nerve)To read this article in full you will need to make a payment
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Article Info
Footnotes
Presented to the 11th International Meeting on Surgical Rehabilitation of the Tetraplegia Upper Limb, June 6-9, 2013, Hong Kong; and the Australian and New Zealand Spinal Cord Society, November 19-21, 2014, Auckland, New Zealand.
Publication of this article was supported by the American Congress of Rehabilitation Medicine.
Disclosures: none.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
