Article

Kenya Tsuge [1] published the first Japanese book on hand surgery in 1965. Only one page was allocated to ''cervical cord injury and functional reconstruction of the hand,'' and it was devoted mostly to the description of Lipscomb's two-stage operation for the cervical cord lesion after fracture dislocation of C6 on C7 [2]. The first stage is reconstruction of the extensors: (1) transfer of the extensor carpi radialis longus (ECRL) to the finger extensors and the rerouted extensor pollicis longus (EPL), (2) occasional transfer of one slip of the extensor carpi radialis brevis (ECRB) to the abductor pollicis longus (APL), and (3) Riordan's intrinsic tenodesis using half a slip of ECRB and the extensor carpi ulnaris (ECU). The second stage is reconstruction of the flexors: (1) transfer of the brachioradialis (BR) to the flexor pollicis longus (FPL), (2) transfer of the pronator teres (PT) to the flexor profundus (FDP), and opponensplasty using the flexor carpi radialis (FCR). At the 10th annual meeting of the Japanese Society for Surgery of the Hand in 1967, Yokoyama et al [3] presented five cases of tetraplegic hands for which functional reconstruction was attempted. An opponensplasty using either FCR or flexor superficialis (FDS) of the ring finger was performed in two of the five cases. Thompson's first-to-second intermetacarpal fusion in palmar abduction associated with transfer of FCR to FDP and of BR to FPL was performed in one case. Results were mainly unsatisfactory because of either insufficient pinch power or spasticity. The patient who underwent intermetacarpal fusion had difficulty supporting the trunk with the operated hand. In the following year, the authors reported three additional cases of intermetacarpal fusion associated with either flexor tenodesis or transfer of ECRB to thumb and finger flexors. Their procedures were not the same as Nickel's ''wrist-driven flexor hinge hand,'' but their work was influenced by his paper published in 1963 [4].

Langue : ANGLAIS

Tiré à part : OUI

Identifiant basis : 2003225786