Restoration of elbow extension and construction of a “key grip” in people with tetraplegia. Comparative study of a surgical plan in one or two stages - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue Orthopaedics & Traumatology: Surgery & Research Année : 2023

Restoration of elbow extension and construction of a “key grip” in people with tetraplegia. Comparative study of a surgical plan in one or two stages

Résumé

Aim: We report the comparative results of functional upper extremity surgery plans in patients with tetraplegia, including restoration of elbow extension and construction of a key grip in a "one-stage" or "two-stage" operation. Materials and methods: A series of 36 patients with tetraplegia, with a total of 45 operated upper limbs, was analyzed retrospectively with a mean follow-up of 23 months (13-39 months). We evaluated the analytical strength of elbow extension using the MRC (Medical Research Council) score, the strength of the key grip (kg/F) as well as the autonomy of the patients using functional scores; Lamb (/100) and QIF (Quadriplegia Index of Function) (/100). Results: Sixteen upper limbs were included in the "one-stage" group and 29 in the "two-stage" group. The groups were comparable preoperatively. Elbow extension strength was 3.6/5 in the one-stage group versus 3.7/5, p=0.74. Grip strength was 1.8kg/F in the one-stage group versus 1.3kg/F, p=0.22. Regarding the functional scores, there was no statistically significant difference between the two groups for the Lamb score (p=0.46) and the QIF (p=0.42). There was no statistically significant difference in terms of the frequency of complications for the elbow (p=0.49) and for the hand (p=0.17). The total duration of the one-stage surgery plan averaged 7.5 months compared to 24.7 months for the two-stage plan, p<0.01. The mean follow-up for the one-stage group was 21 months versus 24 months for the two-stage group. Conclusion: The results of both plans are similar and indicate that the "one-stage" plan is a reliable option. This all-in-one surgical option reduces postoperative follow-up and dropout rates for patients during the plan timeframe.
IV; retrospective clinical series.

Domaines

Chirurgie
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Dates et versions

hal-04521088 , version 1 (26-03-2024)

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Rémi Carré, Michel Chammas, Jacques Teissier, Anthony Gélis, Bertrand Coulet. Restoration of elbow extension and construction of a “key grip” in people with tetraplegia. Comparative study of a surgical plan in one or two stages. Orthopaedics & Traumatology: Surgery & Research, 2023, 109 (5), pp.103375. ⟨10.1016/j.otsr.2022.103375⟩. ⟨hal-04521088⟩
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