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

Surgical Management

The mainstay of quadriplegic upper extremity surgery is tendon transfers. If the patient's needs exceed the number of donor muscles, other procedures, such as tenodesis and arthrodesis, may be used. Contraindications to surgery include active infections, open wounds, poor soft-tissue bed, bony instability or laxity, painful paresthesia, medical instability, spasticity, and joint contractures.