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Paralysis and nerve injuries: Tendon transfer for recovery of mobility in both hands in a patient with quadriplegia

1 December, 2017

Transferencia tendinosa en paciente tetrapléjico_01_20171129

Nerve lesions in their most severe manifestations can lead to paralysis, such as quadriplegia at different levels. These and other situations with nervous affection are approached by Dr. Piñal with advanced microsurgery techniques.

The Spanish surgeon and his team base their clinical perspective on the reassignment of muscle-tendon functions, which involve the development of procedures such as tendon transfers or the autologous transplantation of gracilis muscle, among others.

In this entry of his videoblog, Dr. Piñal presents this type of pictures and analyzes them from a case study: the functional recovery in both hands of David, a young patient, 37 years old, with quadriplegia – lesions level C5 in spinal cord – after suffering a blow to the head while trying to dive.

Zancolli's lasso procedure in paralytic hand
Among the techniques used by Dr. Piñal in this case study are the so-called Zancolli’s lasso procedures (in blue tone, in the center of the limb) whose objective is to avoid the secondary deformity of the claw-hand, once the processes devoted to the functional recovery have been performed.

After the initial traumatic impact, the lesion evolved to C6-C7, with some movement in the arms, but both hands were dysfunctional, without strength and incapable of basic maneuvers such as the clamp.

Dr. Piñal applied a two-stage surgical process on both hands of the patient, using techniques such as tendon transfer or tendon transplantation, in combination with the so-called Zancolli’s lasso procedure.

The result, as can be seen in the images, shows an outstanding recovery of mobility and strength over the initial situation, which gives autonomy back to the patient thanks to the possibility of performing daily tasks such as personal hygiene, small household chores, putting his tube, etc.

Additional info

‘Transfer of gracilis muscle in case of loss of forearm muscles in accident’ 

‘Tendon transfer in case of nerve injury by hand crushing with muscle extrusion’.