Article

Surgical restoration of upper extremity function in tetraplegia is
acknowledged as beneficial, yet in many countries it is underused or absent. This
study describes a 10-year review of a project to implement a tetraplegia upper
extremity surgery service in Hungary. The main aims were to increase awareness
among patients, the medical community and the public about the benefits of this
rehabilitation. The process of implementing a national tetraplegia hand surgery
service is described, together with a retrospective outcome study of upper
extremity function after surgical reconstruction in this service. METHODS: A
total of 141 tetraplegic patients were assessed. Of these, 57 (40%) underwent a
total of 126 reconstructions, including 366 procedures, between 2002 and 2012.
Clinical parameters and patient-perceived results demonstrated improved functions
and abilities. Considerable media attention and scientific presentations
facilitated making this service permanent. In 2009, surgical rehabilitation in
tetraplegia became a recognized part of the rehabilitation protocol in Hungary.
RESULTS: These results suggest that the success of starting a national
tetraplegia hand service relies on convincing postoperative outcomes,
patient-to-patient contacts, and co- operation between rehabilitation
specialists, therapists, health authorities and surgeons. DISCUSSION: The
leadership of dedicated hand surgeons is necessary to provide and disseminate
scientific support for the concept of tetraplegia hand surgery and to stimulate
interdisciplinary communication and educational programmes.

Langue : ANGLAIS