Tetraplegia is a profound impairment of movement of limbs. It manifest as paralysis of all 4 extremities owing to cervical spinal cord injury.
Most of the patients invariably have deformities of limbs and contractures of various joints due to the muscle imbalance. Therapy and splints help preventing the contractures and stiffness.
Surgical restoration of elbow and wrist extension or handgrip has tremendous potential to improve autonomy, mobility, and critical abilities, for example, eating, personal care, and self-catheterization and productive work in at least 70% of tetraplegic patients.
Tendon and nerve transfers, tenodesis, and joint stabilizations reliably enable improved arm and hand usability, reduce muscle imbalance and pain in spasticity, and prevent joint contractures.
One-stage combined procedures have proven considerable advantages over traditional multistage approaches.
Immediate activation of transferred muscles reduces the risk of adhesions, facilitates relearning, avoids adverse effects of immobilization, and enhances functional recovery.
Transfer of nerve fascicles from above the spinal cord injury are effective and promising options to enhance motor outcome and sensory protection, especially in groups with limited resources.
Improved communication between medical disciplines, therapists, patients, and their relatives should help ensure that more individuals can benefit from these advances and could empower many thousands of tetraplegic individuals “to take life into their own hands” and live more independently.