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In the immediate aftermath of severe cervical SCI, most patients present with complete loss of functional capacity of the hand. For some of these patients, it is possible during treatment to restore a certain measure of functional capacity in the hand for daily life activities. In the clinical material we analyzed, however, which included 260 patients recovering from such injuries, 45% of those examined presented with no functional abilities in the hand.
Hand function in patients with tetraplegia is vitally important, since this is a decisive factor in determining the degree of the patient's disability and dependence on others. Accordingly, every effort should be made to improve or restore at least the simplest hand functions in tetraplegics.
This report briefly discusses the methods used to improve functioning of the paretic hand (surgery, orthoses), and also the efforts made to restore some measure of function in the paralyzed hand by the use of an autogenic graft of musculocutaneus nerve into median nerve, and also by the application of functional electric stimulation (FES) using electrodes implanted into median and radial nerves.
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