Surgically restoring hand and upper extremity function in people with tetraplegia is well established with a long, reliable history. Individuals, properly selected and counseled, are consistently pleased with the improvements they gain in terms of both independence and meaningful activities of daily living. Restoration of complex hand functions, such as palmar grasp, tends to involve sophisticated techniques and multiple surgeries in people with lower level tetraplegia. We have identified a subgroup of individuals for whom we have been restoring such function in a single-stage operation. This article will review pertinent concepts of tetraplegia hand and upper extremity restoration with particular focus on the former techniques.
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