Quadriplegics Hand Function Restored With Breakthrough Surgery

For the first time, surgeons in the United States have used a new type of operation called nerve transfer to restore hand function in a quadriplegic patient.  The paralysed patient suffered an injury to the lowest bone in his neck.

Nerve transfers involve taking nerves with less important roles - or branches of a nerve that perform redundant functions to other nerves - and “transferring” them to restore function in a more crucial nerve that has been severely damaged.

Instead of operating on his spine, doctors at Washington University School of Medicine in St Louis used the upper arm nerves to rewire a fresh connection to the patient’s brain. Before the operation, the patient had use of his elbow and shoulder ::::

Elbow flexing requires movement of two muscles — the biceps muscle and the brachialis muscle. In a double fascicular nerve transfer, the surgeon uses portions of two separate nerves that are normally not connected to the biceps and brachialis muscles to restore elbow flexion. During the procedure, a segment of the ulnar nerve, which allows wrist flexion, and a segment of the median nerve, which provides finger or wrist flexion, are cut and transferred directly to the biceps and brachialis branches of the musculocutaneous nerve.

After a year of intensive rehabilitation, the patient gained the ability to pinch, feed himself and even write with some assistance.

WARNING! CONTAINS SURGICAL PROCEDURE

Recovery of function after any nerve reconstruction can be a long process. Some patients have seen small signs of recovery as early as two months after the operation, but in most cases, return of function begins somewhere around six months, with full recovery in about two years.

Surgeons say the procedure had a good chance of success because of its simplicity.

source: abc

source: wustl-center for nerve injury & paralysis