Sequential advancing flexion retention attachment: a locking device for the wrist-driven flexor hinge splint.

The Sequential Advancing Flexion Retention Attachment (SAFRA) was developed for cervical spinal cord-injured patients with a muscle grade of poor to fair in the wrist extensors. It is used on a standard wrist-driven flexor hinge hand splint with adjustable tenodesis bar. Through the development of the SAFRA, maintained prehension can be obtained without externally powered devices such as CO2 or electrically powered orthoses. The patient's increased functional abilities are discussed and advantages summarized.