Expected outcome for reconstructive hand surgery after spinal cord injuries related to level of injury and sex

This retrospective, multicentre study maps grip strength and grasp ability after tendon transfer surgery in patients with tetraplegia. Data were analysed in the whole group and in subgroups stratified into the International Classification for Surgery of the Hand in Tetraplegia (ICSHT) and sex. In total, 200 arms (143 patients) had tendon transfer surgery to restore grip and pinch function, 74% were men, 42% were ICSHT group ≤3 and 58% ICSHT were group ≥4. The one-year outcome across all participants for grip strength was 5.2 kg, pinch strength 2.1 kg and a score of 108 for the Grasp and Release test. Men had significantly higher grip and pinch strength compared to women, while there was no significant difference with respect to grasp ability. ICSHT group ≥4 had significantly higher grip strength and grasp ability compared to ICSHT group ≤3, whereas no significant difference in pinch strength between ICSHT groups was seen.<b>Level of evidence:</b> III.