Outcome from a brachialis donor for wrist extension in tetraplegia-time to reconsider the International Classification for Surgery of the Hand in Tetraplegia (ICSHT).
INTRODUCTION: Surgical reconstruction after quadriplegia represents a powerful solution to restore lost function by injury. A case is presented in which surgical reconstruction of a patient with a C4 level spinal cord injury is performed using the brachialis (BRA) muscle as the donor. CASE PRESENTATION: The patient previously had no hand function. This transfer, in combination with fusion of the thumb CMC joint and transfer of the flexor pollicis longus (FPL) tendon to the radius, gives the patient full thumb key pinch powered by BRA transferred to the wrist extensors. Theoretical analysis of
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