[Gaining uniform active muscle function by "in situ tendon transplant" in surgical rehabilitation of the upper extremity of tetraplegic patients. A case report].

The results of tendon transfers in the tetraplegic upper limb are encouraging. In contrast to the cases with peripheral nerve injury or polio, the availability of active muscles for transfers is very limited in tetraplegics. In both hands of a tetraplegic patient with Group 4 according to the international classification the brachioradialis was transferred to FPL and ECRL to FDP 2-5. The Zancolli-Lasso-procedure was performed in both hands as well as tenodesis of EPL proximally to the wrist. On the right side stabilisation of the thumb was achieved by CMS-1-fusion and on the left side the thumb got control by an abductor transfer using pronator teres and an interpositional tendon graft of the paralysed FDS 2. The result is described. Grip strength and Sollerman test were measured. Advantages and disadvantages of the two different procedures for thumb control are discussed, and the different abilities of gripping are shown.