Combined Nerve and Tendon Transfer for the Restoration of Hand Function in Individuals With Tetraplegia
Recruiting now
Conditions studied: Spinal Cord Injury Cervical, Tendon Transfer, Nerve Transfer, Rehabilitation, Grip Function
In brief
Tetraplegia after a cervical spinal cord injury (C-SCI) radically alters an individual's ability to perform normal activities of daily life due to paralysis in all extremities, resulting in lifelong dependence.\[1\] Traditional tendon transfer surgery has proven successful in restoring grip functions which greatly improves autonomy, but with a restricted passive opening of the hand. The number of transferrable muscles in the arm is however limited, why nerve transfer surgery is a new attractive option to further improve hand function by enabling active opening of the hand. Significant advantages of distal nerve transfers include less extensive surgical dissection, greatly reduced hospital stay, rehabilitation and restrictions, and thereby less health care use and costs. In an effort to further improve hand function and independence in patients with tetraplegia, hand surgeons at Centre for Advanced Reconstruction of Extremities (C.A.R.E.), Sahlgrenska University Hospital (SUH)/Mölndal have developed a strategy in which a nerve transfer procedure aiming to restore active opening of the hand is done prior to reconstruction of grip functions. To date, no study has compared the efficacy of this combined nerve and tendon transfer (CNaTT) procedure to traditional grip reconstruction by means of tendon transfer alone, thus constituting a major gap in the literature. The purpose of this study is therefore to fill that knowledge gap by comparing the clinical outcomes of a cohort of patients who undergo the CNaTT procedure to restore hand function, to those treated by means of tendon transfer alone.
Key facts
- Study ID
- NCT04276181
- Run by
- Göteborg University
- People needed
- 94
- Starts
- 2020-01-26
- Expected to finish
- 2026-12-31
- Last updated by the study team
- 2024-08-09
Who can join
Age: 15 and older, up to 55. Sex: any. Healthy volunteers: not accepted.
You may qualify if…
- Subjects must be between 15-55 years of age
- Subjects must be diagnosed with a spinal cord injury AIS level C5 to C7
- Time after injury ≤ 12 months
- The strength of the muscle supplied by the donor nerve (supinator) must be graded ≥ 4 according to Medical Research Council (MRC)
- The strength of musculus brachioradialis and wrist extensors must be graded ≥ 4 according to MRC (to be used in grip reconstruction)
You may not qualify if…
- Finger extensor strength ≤ MRC 1
- Evidence of lower motor neuron injury in muscles supplied by the donor nerve
- Subjects must not have any current serious or unstable illness that could interfere with the study
- Medically unstable to undergo surgery as determined by physician
- Spasticity in the forearm or hand graded > 1 according to Modified Ashworth Scale
Where it is running
- Center for Advanced Reconstruction of Extremities, Sahlgrenska University Hospital/Mölndal — Mölndal, Sweden (enrolling)
Full record on ClinicalTrials.gov
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