PRS Journal Club Upper Extremity Surgery in Cervical SCI” with Harvey Chim, MD - Dec. 2024 Journal Club
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Dec 11, 2024 Explore the groundbreaking approaches to upper extremity surgeries for cervical spinal cord injuries. Discover how timing and rehabilitation strategies impact patient outcomes. The discussion highlights impressive gains in mobility and independence through nerve and tendon transfers. Learn about the crucial role of personalized treatment plans, with an emphasis on enhancing grip strength for daily activities. Insights from a renowned expert shed light on the complexities and successes of these innovative surgical interventions.
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Nerve/Tendon Transfers for SCI
- Nerve and tendon transfers benefit upper extremity function in spinal cord injury patients.
- Good outcomes are possible even years after injury due to preserved neuromuscular connections.
Combined Approach for Upper Extremity Function
- Dr. Chim prefers a combined approach using supinator to PIN nerve transfer for finger extension and ECRL to FTP tendon transfer for flexion.
- Prioritize grip strength, especially for tetraplegic patients, as it's crucial for daily activities.
Post-op Rehab Protocol
- For tendon transfers, immobilize for 4-6 weeks, followed by active range of motion and splint weaning.
- For nerve transfers, immobilization or immediate active ROM depends on the patient and their ability to follow instructions.