Deltoid triceps transfer and functional independence of people with tetraplegia

Study design: Matched case control study. Setting: Two regional spinal units-Salisbury, UK (surgical centre) and Lond on, UK (control centre). Objective: To compare the functional independence and wheelchair mobility o f spinal cord injured subjects, post deltoid triceps transfer, with matched control subjects. Methods: Two matched groups of subjects, with tetraplegia resulting in tric eps paralysis, were studied. The surgical group consisted of five of the si x patients who had previously undergone deltoid triceps transfer at Salisbu ry. The control group (n=6) had not undergone surgical intervention but wer e comparable with respect to level of lesion, age, age at injury and durati on of disability. All subjects completed standardised assessments of activi ties of daily living (Functional Independence Measure-FIM) and wheelchair m obility (10 m push and figure of 8 push). Surgical subjects completed addit ional questions, regarding the perceived effects of surgery on function. Results: It was not possible to demonstrate absolute functional differences with the chosen outcome measures in this small series of matched case cont rols. All surgical subjects cited specific functional improvements since su rgery and recommended the procedure. However the FIM lacked sufficient sens itivity to detect these changes. Conclusion: Further investigation of the functional outcome of deltoid tric eps transfer in tetraplegia is warranted. Development of more sensitive out come measures would be useful.