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The long-term results of the key grip procedure (tenodesis of the flexor pollicis
longus tendon to the radius, release of the A1 pulley, and percutaneous pin fixation
of the interphalangeal joint of the thumb) were evaluated in 10 tetraplegic patients.
Seven patients also had tenodesis of the extensor pollicis longus and brevis tendons
to prevent flexion at the metacarpophalangeal (MP) joint. Patients were examined an
average of 7.4 years after surgery. Progressive flexion of the MP joint gradually
occurred, indicating failure of the extensor tenodesis. Excessive bowstringing of
the flexor pollicis longus tendon across the MP joint occurred in nine patients. Because
of failure of the extensor tenodesis and bowstringing of the flexor tendon, the patients
had to progressively extend the wrist further to pinch small objects. Functional testing
demonstrated improved hand use in eight patients. Lateral pinch strength was related
to wrist extension torque.
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Article info
Publication history
Accepted:
November 19,
1985
Received:
July 29,
1985
Footnotes
+Supported in part by National Institute of Handicapped Research Grant No. G008402231.
Identification
Copyright
© 1986 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
