Outcome of combined nerve and tendon transfer in tetraplegia: a new surgical strategy to restore grasp function

This study aimed to assess the outcome of supinator to posterior interosseus nerve transfer, followed by tendon transfer, to restore grasp function in patients with mid-to-high-level cervical spine injuries. Fifteen upper limbs in 11 patients with these injuries were included. The outcomes were then compared with a historical control group consisting of 16 upper limbs that received tendon transfers alone. The outcome was assessed using the Canadian occupational performance measure, ability to open the first web space, and grip and pinch strength 12 months after surgery. The Canadian occupational performance measure was similar in both groups, even though the study group had more severe preoperative impairment. The grip strength was significantly lower in the study group, whereas pinch strength was similar between the groups. This study suggests that a combined nerve and tendon transfer in patients with tetraplegia may offer benefits.<b>Level of evidence:</b> III.