Evidence for efficacy of new developments in reconstructive upper limb surgery for tetraplegia.

Nerve transfers are increasingly utilized for upper limb reconstruction in tetraplegia. We reviewed the literature for results achieved by nerve transfers for elbow extension, wrist control and finger and thumb flexion and extension. Muscle strength grading was the only outcome measure consistently reported.

Upper limb surgery for severe spasticity after acquired brain injury improves ease of care.

For individuals with acquired brain injury and severe upper limb spasticity, personal care is often difficult, time-consuming and painful. Previous studies on outcomes after surgery for upper limb spasticity have focused on functional gain, pain, hygiene and appearance. We operated on 38 non-communicative patients (45 limbs, 535 procedures) with severe spasticity and a non-functional upper limb(s).

Surgical management of forearm pronation.

Active volitional supination enhances upper limb function. In the spastic forearm with pronation deformity, careful preoperative assessment of muscle function is necessary to design a treatment plan to improve supination. Concomitant procedures performed for flexion contractures have to be taken into consideration.

The intravenous foreign body: a report of 2 cases.

Two cases of metallic foreign body injury to the upper limb are described. In both cases the foreign body was clearly visible on x-rays, considered to be lodged in the soft tissues, but migrated to one of the large subcutaneous veins. One subsequently migrated to the heart; the other was removed from the peripheral vein.