The time between surgery and the first consultation in our unit varied from three to nine years (mean five years four months). Persistent stiffness had been noted in the postoperative period with pain at joint mobilisation which worsened progressively. For the patients with chondrolysis of the wrist: the x-rays demonstrated destruction of the radius-first ray joint in one, the medio-carpal joint in four and overall destruction in two. Overall joint destruction was also observed in the elbow and shoulder patients. Search for other causes of joint destruction was negative; infection and inflammatory rheumatoid disease were ruled out. The common feature identified in all patients was joint irrigation with a chlorhexidine solution (Biseptine®).
Results: Mean hospital stay was shortened compared with the control group 4.1±0.8 months versus 10±1.0 months). Elbow extension force according to the BMRC scale was 3.8±0.6 in Group A versus 3.5 for the control group and 3.2±0.5 for Group B compared with 2.8 for the control group. Mean active key grip force was 1.8±0.9 kg for Group A versus 1.9 for controls and 0.9±0.6 kg for the passive key grips in Group B versus 0.9 for controls. Functional independence improved postoperatively, the QIF improved from 40.0±18.0 to 55.2±17.0. Discussion: This work demonstrated that a single operation shortens hospital stay without affecting the final outcome and that the brachioradial can be transferred on the flexor pollicis longus for reactivation of elbow extension. In our experience, only 46% of the tetraplegic patients starting a functional surgery programme benefit from reactivation of the elbow and hand. Procedures performed during a single operation allow a more systematic approach.
The weight of the Ta increased for both cardiotoxin doses. There was an increase in the size of the fibres with or without SC transfer.