Pulp-to-Pulp Pinch Reconstruction in a Tetraplegic Patient Utilizing Nerve and Tendon Transfers: A Case Report

In tetraplegia, hand reconstruction is of high priority. Key pinch has been advocated for tetraplegia because the lack donors nerve and tendon transfers. We report a patient with mid-cervical who underwent transfers in right left upper limbs seven months post-injury to reconstruct function. The particularity our case resides left-hand thumb index pulp-to-pulp reconstruction. For this, we transferred supinator posterior interosseous extensor carpi radialis brevis anterior nerve. During second surgery, relieved clawing by transferring split flexor digitorum superficialis middle ring fingers, motored brachioradialis, apparatus all fingers. Finally, achieve better palmar abduction, osteotomized scaphoid tubercle fixed it distal radius while maintaining thenar muscle attachments. Five years after was able grasp release small objects placed on table becoming left-handed. Here, demonstrated that pinch-to-pinch possible, which increased use daily activities, especially during eating grabbing over table.