Research Article| Volume 11, ISSUE 5, P724-728, September 1986

Long-term follow-up of the Moberg key grip procedure

  • Thomas V. Rieser
    Regional Spinal Cord Injury Care System of Southern California, Rancho Los Amigos Medical Center, Downey, Calif.
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  • Robert L. Waters
    Reprint requests: Robert L. Waters, M.D., Clinical Professor of Orthopedic Surgery, University of Southern California, Rancho Los Amigos Medical Center, 7601 E. Imperial Hwy., Downey, CA 90242.
    Regional Spinal Cord Injury Care System of Southern California, Rancho Los Amigos Medical Center, Downey, Calif.
    Search for articles by this author
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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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