Some thoughts on the current state of treatment of the upper limb in traumatic tetraplegia.

Traumatic tetraplegia often affects healthy young men. The medullary lesion is located at C6 in 75% of cases. The author on the basis of 20 years of experience believes it possible to improve independence and life quality by surgical procedures such as tendon transfers, which are the most often used, for restoring two important functions: active elbow extension and active hand grip. The restoration of elbow extension is accomplished by Moberg's procedure of transferring the posterior tendon of the deltoid onto the triceps. The results are very satisfactory. To restore hand grip the author makes use of the first radial tendon transferred onto the deep common flexor, and for the thumb, the long supinator onte the long flexor of the thumb. Definite functional improvement was found in 33 of 45 cases.