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Posterior Deltoid-to-Triceps Tendon Transfer for Elbow Extension in a Tetraplegia Patient: A Case Report

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키워드

주제분류재활의학

초록

In tetraplegia patients, activities of daily living are highly dependent on the remaining upper limb functions. In other countries, upper limb reconstruction surgery to improve function has been applied to diverse cases, but few cases have been reported in Korea. The current authors experienced a case of posterior deltoid-to-triceps tendon transfer and rehabilitation in a complete spinal cord injury with a C6 neurologic level, and we introduce the case—a 36-year-old man—with a literature review. The patient’s muscle strength in C5 C6 muscles were normal, but C7 muscles were trace, and the Spinal Cord Independence Measure III (SCIM III) score was 24. The tendon of the posterior deltoid was transferred to the triceps brachii muscle, and then the patient received comprehensive rehabilitative treatment. His C7 muscle strength in the right upper extremity was enhanced from trace to fair, and his SCIM III score improved to 29.

Abstract

In tetraplegia patients, activities of daily living are highly dependent on the remaining upper limb functions. In other countries, upper limb reconstruction surgery to improve function has been applied to diverse cases, but few cases have been reported in Korea. The current authors experienced a case of posterior deltoid-to-triceps tendon transfer and rehabilitation in a complete spinal cord injury with a C6 neurologic level, and we introduce the case—a 36-year-old man—with a literature review. The patient’s muscle strength in C5 C6 muscles were normal, but C7 muscles were trace, and the Spinal Cord Independence Measure III (SCIM III) score was 24. The tendon of the posterior deltoid was transferred to the triceps brachii muscle, and then the patient received comprehensive rehabilitative treatment. His C7 muscle strength in the right upper extremity was enhanced from trace to fair, and his SCIM III score improved to 29.

참고문헌 (10)

  1. Bryce TN, "Physical medicine and rehabilitation", pp.1293~1346 (2011), Saunders
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  4. Wuolle KS, "Satisfaction with upper-extremity surgery in individuals with tetraplegia", Arch Phys Med Rehabil, 84, pp.1145~1149 (2003)
  5. Dunn JA, "The effects of aging on upper limb tendon transfers in patients with tetraplegia", J Hand Surg Am, 39, pp.317~323 (2014)
  6. Raczka R, "Posterior deltoid-totriceps transfer in quadriplegia", Clin Orthop Relat Res, (187), pp.163~167 (1984)
  7. Friden J, "Evidence for muscle attachment at relatively long lengths in tendon transfer surgery", J Hand Surg Am, 23, pp.105~110 (1998)
  8. Bonds CW, "Posterior deltoid-to-triceps tendon transfer to restore active elbow extension in patients with tetraplegia", Tech Hand Up Extrem Surg, 13, pp.94~97 (2009)
  9. Grangeon M, "Rehabilitation of the elbow extension with motor imagery in a patient with quadriplegia after tendon transfer", Arch Phys Med Rehabil, 91, pp.1143~1146 (2010)
  10. 이상윤, "사지마비 환자에 대한 상지 재건술: 국내 실태와 활성화 방안", Annals of Rehabilitation Medicine, 32(2), pp.175~181 (2008), 대한재활의학회

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