1Division of Plastic Surgery, Department of Surgery (S.R.C.), and Division of Hand Surgery, Department of Orthopedic Surgery (P.C.R.), Mayo Clinic, Rochester, Minnesota.
JBJS Rev. 2020 Jul;8(7):e1900210. doi: 10.2106/JBJS.RVW.19.00210.
Management of tetraplegia should be individualized to a patient's particular deficiencies and functional goals. Surgical decision-making for upper-extremity reconstruction in patients with tetraplegia relies on a thorough physical examination to determine which nerves and muscles remain under volitional control with adequate strength for transfer. Peripheral nerve transfers, either in conjunction with or in place of traditional tendon transfers, enable providers to offer an expanded set of surgical options for patients with tetraplegia who are seeking upper-extremity reconstruction. All upper-extremity reconstructive efforts should be carefully considered with regard to their potential effects on the availability of future reconstructive efforts.
四肢瘫痪的管理应根据患者的特定缺陷和功能目标进行个体化。四肢瘫痪患者上肢重建的手术决策依赖于全面的体格检查，以确定哪些神经和肌肉仍然在自主控制下，具有足够的力量进行转移。周围神经转移，无论是与传统肌腱转移结合使用还是替代传统肌腱转移，都使提供者能够为寻求上肢重建的四肢瘫痪患者提供一套扩展的手术选择。所有上肢重建的努力都应仔细考虑其对未来重建努力的可用性的潜在影响。
