'Internal Splints' for Tetraplegics

Abstract

The “Internal Splint for Tetraplegic Patients” concept is being used at the Spinal Units of the H.F, Verwoerd Hospital and Kalafong Hospital in Pretoria. It consists of:

1. An improved “bone-to-bone” posterior deltoid to triceps tendon transfer: for elbow extension.

2. Biceps tendon transfer: changing a supination deformity to a functional pronation.

3. Finger and, thumb extension: using brachioradialis.

4. Finger flexion and thumb adduction against the fingers using extensor carpi radialis longus to motorise flexor digitorum profundus and rerouting the flexor pollicis longus tendon to the extensor carpi radialis brevis tendon. Promote metacarpophalangeal flexion by the Zancolli lasso operation and stabilizing the thumb by fusion of one of its joints.

These functional operations contribute greatly to a more independent management of daily activities. Certain prerequisites must be met, e.g. muscle power and endurance. Individual assessment done by the rehabilitation team is of utmost importance.