Management of Upper Extremities in Tetraplegia

Current Concepts

Michael S. Bednar, MD; Julie C. Woodside, MD


J Am Acad Orthop Surg. 2018;26(16):e333-e341. 

In This Article

Patient Limitations and Goals

Patients with cervical spinal cord injuries face many physical, functional, and psychological limitations. Physically, they have limited or absent grip and pinch strength. When triceps function is absent, they have difficulty with overhead activities. Functional limitations, including mobility, transfers from bed to chair, ADL performance, and independence with work tasks are affected. Finally, the appearance of the hand may affect patients' confidence in social interactions. When patients with tetraplegia are asked which function they would most like to have restored, 75% chose upper extremity function, 13% chose bowel and bladder use, and 3% chose sexual function.[9]