Physiotherapy - Research Publications

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Author: Galea, Mary × Author: Hill, Bridget × End date: 2021 × Start date: 2020 ×

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    Reanimating hand function after spinal cord injury using nerve transfer surgery
    Galea, M ; Messina, A ; Hill, B ; Cooper, C ; Hahn, J ; van Zyl, N (Whitehouse Publishing, 2020-03)
    Loss of arm and hand function is a devastating consequence of cervical spinal cord injury. Tendon transfer surgery has traditionally been used to restore key functions including elbow extension, wrist extension and grasp and pinch. The more recent development of nerve transfer surgery enables direct restoration of voluntary control of these functions. While both types of surgery are safe and effective, nerve transfer surgery results in a more open, flexible and natural hand, with more subtle control for a range of activities of daily living.
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    Transfer of the supinator nerve to the posterior interosseous nerve for hand opening in tetraplegia through an anterior approach
    van Zyl, N ; Galea, MP ; Cooper, C ; Hahn, J ; Hill, B (SAGE PUBLICATIONS LTD, 2021-09)
    We report a retrospective series of 44 transfers in 26 patients in whom a functioning supinator nerve was transferred to a paralyzed posterior interosseous nerve through a single, anterior approach to re-animate hand opening in mid-cervical tetraplegia. Eighteen patients underwent concurrent nerve or tendon transfers to re-animate grasp and/or pinch through the same anterior incision. We evaluated the strength of the innervated muscle at mean follow-up of 24 months (range 12-27). The strength attained in our patients was equivalent to the strength after the transfer through a posterior approach reported in the literature. Nineteen of our patients were satisfied with the hand opening procedure. First webspace opening was the only variable to correlate with patient satisfaction. We conclude that the anterior approach yields similar results to the posterior approach and has the advantage of allowing easier access for simultaneously performing nerve or tendon transfers to reconstruct grasp and pinch.Level of evidence: IV.