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Reconstructive Surgery and Tendon Transfers

Reconstructive surgery is one option when trying to improve the function of the hand and upper limb in persons with tetraplegia. Functionally, the benefit of reconstructive surgery may be evident through improved ability to write, complete catheterizations, dress, self-feed, drive, lift objects, button, propel the wheelchair, catch objects overhead, turn in bed, and swim, which are only some of the activities that can become possible after surgery (Rabischong et al., 1993). Surgery has been reported to improve quality of life for those people who had little or no upper limb function (Freehafer et al., 1984). Despite the potential benefits, the option to receive reconstructive surgery in persons with SCI is often declined. This decision is influenced by a temporal element including hope for a cure or recovery from SCI (Dunn et al., 2013). It has been recommended that persons with SCI be offered upper limb surgery multiple times throughout their lives to consider changes in perspective. Flexibility of the timing for surgery and the type of rehabilitation offered may also help to increase the uptake of surgery (Dunn et al., 2013).