Article

OBJECTIVE: To describe and evaluate the rehabilitation concept after posterior
deltoid to triceps transfer in patients with tetraplegia.
DESIGN: Retrospective
observational study.
SETTING: Rehabilitation units. PARTICIPANTS: Patients with
tetraplegia who had posterior deltoid to triceps tendon transfer and had muscle
strength measurements 1 year postsurgery from 2009 to 2013 (N=44). INTERVENTIONS:
Posterior deltoid to triceps tendon transfer to restore elbow extension and
postoperative rehabilitation. MAIN OUTCOME MEASURES: Elbow extension range of
motion and muscle strength and the modified Canadian Occupational Performance
Measure (COPM). RESULTS: Surgery was performed on 53 arms. No major complications
(eg tendon rupture, lengthening) were reported. Muscle strength measured 1 year
after surgery was on average grade 3 (out of 5) in the 53 operated arms. The
ability to extend the elbow against gravity was achieved in 62% of the arms
(muscle strength of grade >/=3). In patients with a preoperative elbow extension
deficit (n=14), the deficit was reduced on average from 16 degrees to 9 degrees .
The performance of the prioritized activities as measured with the COPM improved
on average 2.6 scale steps, from 3.3 to 5.9. Satisfaction with the performance
improved on average 3.2 scale steps, from 2.8 to 6.0. CONCLUSIONS: The posterior
deltoid to triceps tendon transfer with the applied rehabilitation protocol is a
safe and effective procedure. There were no tendon ruptures, and all patients
were able to complete the rehabilitation protocol. The shorter restriction time
after surgery allows the patient to be independent at an earlier stage of the
rehabilitation and reduces hospitalization or care burden.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS