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J Am Acad Orthop Surg, Vol 12, No 2, March/April 2004, 72-79.
© 2004 the American Academy of Orthopaedic Surgeons

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Implanted Neuroprostheses for Restoration of Hand Function in Tetraplegic Patients

Roger Cornwall, MD and Michael R. Hausman, MD

Dr. Cornwall is Orthopaedic Hand Surgeon, Children’s Hospital of Philadelphia, and Assistant Professor of Orthopaedic Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA. Dr. Hausman is Professor and Chief of Hand and Elbow Surgery, Leni and Peter W. May Department of Orthopaedics, Mount Sinai Hospital, Mount Sinai School of Medicine, New York, NY.

Reprint requests: Dr. Hausman, Mount Sinai Hospital, Box 1188, 5 East 98th Street, New York, NY 10029.

Restoration of hand function through functional electrical stimulation allows tetraplegic patients to use existing abilities to control paralyzed muscles. In patients with C5 or C6 spinal cord injuries, implanted upper extremity neuroprostheses use functional electrical stimulation technology to power hand and arm muscles. A variety of devices, often using contralateral shoulder motion, sends signals via a small external controller and transmitting coil to an implanted stimulator. The stimulator powers designated upper extremity muscles via implanted electrodes. The surgical procedure is minimally invasive and easily reversed. Palmar and lateral grasp, among other functions, can be reliably restored, leading to significant improvements in functional capacity. High user satisfaction, low complication rates, and recent advances in technology and control systems contribute to the success of this technology in the treatment of devastating spinal cord injuries.







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