Functional reconstruction of the upper extremity in tetraplegia. Application of Möberg's and Allieu's procedures.

The authors conducted a retrospective study to evaluate the benefit of 43 reconstructive procedures and tendon transfers, performed in 37 sessions to restore hand and arm function in 25 tetraplegic patients. These operative procedures were either single or multiple, depending on the patients' needs for restoration. The initial clinical situation was assessed based on a simplified version of the international classification of Giens, modified in Edinburgh. The results were evaluated through clinical assessment and simple functional testing. Gestural ability was improved in more than 80% of the patients and functional gain was important in more than half. The authors conclude that selected tetraplegic patients can benefit from these procedures. The diversity of clinical situations and the variety of surgical procedures result into small scattered series unfit for statistical analysis, and there is a need for unequivocal, internationally recognised assessment methods.