Fromm B, Rupp R, Gerner H J
Abteilung Orthopädie II-Rehabilitationsmedizin, Orthopädische Universitätsklinik, Heidelberg.
Handchir Mikrochir Plast Chir. 2001 May;33(3):149-52. doi: 10.1055/s-2001-15129.
We report on the first experience with the Freehand system in German-speaking countries, an implantable neuroprosthesis developed for the functional electrical stimulation of the upper extremity. Indications for its use are neurological deficits of the cervical spinal cord with active mobility of the shoulder and elbow flexion in tetraplegics, ideally in C5/6 tetraplegics. A further precondition for the implantation of this system is an intact reflex arc of the muscles that are to be stimulated, i.e. of the forearm and hand. Central defects such as hemiparesis, cerebral palsies or athetoid disorders or peripheral nerve palsies (e.g. brachial plexus lesions) are no good indications for the implantation of the Freehand system. We report on patient selection criteria, preoperative percutaneous electrical stimulation, the surgical procedure itself with optional active tendon transpositions, the intensive postoperative rehabilitation program until the patient is able to use the system independently and the life-long after-care.
我们报告了在德语国家首次使用Freehand系统的经验，该系统是一种为上肢功能性电刺激而开发的植入式神经假体。其适用指征为四肢瘫痪患者中存在颈脊髓神经功能缺损且肩部可主动活动、肘部可屈曲，理想情况是C5/6节段四肢瘫痪患者。植入该系统的另一个前提条件是拟刺激肌肉（即前臂和手部肌肉）的反射弧完整。诸如偏瘫、脑瘫或手足徐动症等中枢性缺陷或周围神经麻痹（如臂丛神经损伤）均不是植入Freehand系统的良好指征。我们报告了患者选择标准、术前经皮电刺激、包括选择性主动肌腱移位的手术过程本身、直至患者能够独立使用该系统的强化术后康复计划以及终身随访情况。
