1. Praxis
«Hands are some of the most
A handful of freedom fascinating phenomenon that exists»
Suddenly raise your arm and grab something with force – the wish for many tetraplegics. Hopeless cases? No, that does not exist for in everyday life. Therefore, operations are Tendons and muscles
Thanks to surgery, it is now possible to awaken paralyzed hands to new life. the two doctors. «We can almost always offer usually performed at the earliest six months The surgical procedure is delicate: The sur-
an improvement», says Simeon Grossmann. after hospital discharge. Professor Jan Fridén geons use intact, upper – or forearm muscles
Before leaving the SPC after about nine says: «We ask the patients to present the five and their tendons to connect with certain
months of rehabilitation, the patients meet most important abilities to regain after tendons of the hand. This effectively makes
Text: Christine Zwygart | Photos: Astrid Zimmermann-Boog, Walter Eggenberger again with the Tetrahand team to share in- surgery to make sure that the outcome of the muscle to perform new tasks e.g. so fin-
formation. However, before an intervention the procedure will meet the needs of the gers, previously paralyzed, can move and flex
is planned, patients need to gain experience patient.» and stretch again. We restore both closing
A loved one to touch. A child to put to
sleep. Or someone to welcome warmly.
«The hands belong to an individual’s person-
he is the professor of hand surgery and
leader of the Swedish Center for tetraplegia
hand surgery at University Hospital in Goth-
The doctors in Jan Fridén, Bijan
Cheikh-Sarraf and Simeon Grossman
(left) inspect the hand of a patient
ality. They show emotions, can carress, but enburg. «It is a stroke of luck that we can with tetraplegia.
also beat», says Jan Fridén, specialist in Tetra work together with him», says Grossmann.
Hand Surgery. Eight fingers and two thumbs
– together they assist us in communicating Strength and flexibility
and are indispensable helpers in so many Consultation in Nottwil. The two surgeons,
performances in everyday life. By a spinal occupational and physical therapists and
cord injury, can hands, arms and shoulders physicians from the Department of Ortho-
be weak, stiff and numb. The higher up the pedic Surgery and Spinal Cord Injury par-
spinal cord is damaged, the more serious are ticipate in the consultations. Today’s sched-
the limitations. For those concerned, this uled patients represent different phases of
means losing some of their independence. the Tetrahand service: those who will soon
Simple things – opening a bottle, reaching be operated on, others who have already
for a book or putting on a sock – the spinal passed the biggest efforts and come for the
cord injured persons have to cope with daily follow-ups. Also newly injured patients
tasks that are difficult or even impossible to come to learn about possibilities of further
perform. «With an operation we can now en- improvement.
sure that certain functions of paralyzed A young man comes rolling in, he drives the
hands can be restored», says Jan Fridén. To- wheels awkwardly with the heel of the hand.
gether with physician colleague Simeon The doctors want to see whether the patient
Grossmann in the Swiss Paraplegic Centre can move his joints better since the previous
(SPC) in Nottwil, he can restore the hand test. «When intervention would be useful,
function of the injured person and thereby those concerned should strengthen the ex-
help to get a bit of freedom back. isting muscles and train the mobility of the
210 consultations have been done by the two joints», says Jan Fridén. «If someone is not
doctors in the past year, and more than 30 willing to make this effort, there will be no
surgical procedures have been performed. operation.» Using simple exercises like
This year the team expects an increase in stretch your arm, bend your thumb tests the
treatment because of the highly specialized patients’ mobility and strength is tested. The
area is still under build-up in the SPC. Tetra- experts register exactly what is possible, how
hand expert Jan Fridén has been working powerful the muscles work and what does
regularly here since January 2011. Otherwise, not work at all.
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