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

Annals of Rehabilitation Medicine, 2016 · DOI: http://dx.doi.org/10.5535/arm.2016.40.2.351 · Published: April 1, 2016

Spinal Cord Injury Surgery Rehabilitation

Simple Explanation

This case report describes a surgical procedure called posterior deltoid-to-triceps tendon transfer used to improve elbow extension in a patient with tetraplegia (paralysis of all four limbs). The patient, a 36-year-old man with C6 tetraplegia, underwent this procedure, followed by a rehabilitation program that included motor imagery and biofeedback. The goal was to restore the ability to extend his elbow, which is essential for performing daily activities and improving his overall quality of life.

Study Duration

24 weeks

Participants

One 36-year-old male with C6 tetraplegia

Evidence Level

Level IV, Case Report

Key Findings

1
The patient's C7 muscle strength in the right upper extremity improved from trace to fair after the tendon transfer and rehabilitation.
2
The patient's Spinal Cord Independence Measure III (SCIM III) score increased from 24 to 29, indicating improved independence in activities of daily living (ADLs).
3
Postoperative intensive rehabilitation therapy improved the general muscle force in the upper limbs.

Research Summary

This case report presents the experience of a posterior deltoid-to-triceps tendon transfer and rehabilitation in a 36-year-old male with complete C6 tetraplegia, aiming to improve elbow extension. The patient showed improvement in C7 muscle strength and SCIM III score after the surgery and comprehensive rehabilitation, indicating enhanced muscle force and functional improvements in ADLs. The authors suggest that more active research on upper limb function surgery as a part of aggressive rehabilitation therapy could improve upper limb functions and quality of life for tetraplegia patients.

Practical Implications

Improved ADLs

Tendon transfer surgery can enhance independence in daily tasks like dressing and transfers.

Increased Muscle Strength

Rehabilitation following surgery can lead to measurable gains in muscle strength in affected limbs.

Enhanced Quality of Life

Successful tendon transfer and rehabilitation can significantly improve the overall quality of life for tetraplegia patients.

Study Limitations

1
The outcome of hand-held dynamometry can be affected by the measuring posture and the rater’s physical condition.
2
Inter-rater reliability is relatively poor.
3
Single case report limits generalizability.

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