Saturday, May 22, 2010

Claes Hultling's message

"Dear folks!
I’m addressing this on Professor Jan Fridén’s web site because I feel the urge to do it since a large number of tetraplegics are still lacking proper hand surgery service. I’m a 57 year-old Visiting Professor at Stanford University in Palo Alto, California. I’m a M.D., Ph.D., and I was a trained anesthesiologist in 1984 when I had my C6-C7 spinal cord fracture. I had a fairly good right hand but on my left hand and arm I was lacking the majority of the muscles that normally operate my hand. I had two muscles left: musculus extensor carpi radialis longus and musculus extensor carpi radialis brevis. I did know that something could be done with either of these muscles to achieve a flexion grip in my left hand. I was fortunate to get in contact with the late Eric Moberg who is one of the fathers of modern hand surgery. Together with his collaborators at the Sahlgrenska Hospital in Gothenburg on the west side of Sweden surgery was performed the 15th of April, 1985, which was 10 and half months after my spinal cord injury. This is one of the best medical moves I made since I broke my neck.
Why is that? One important element was the timing. One should wait long enough in order to make sure that you don’t regain function and are embarking on hand surgery too early. The other thing is to do it early enough in order to avoid starting to develop secondary techniques that will be perceived as an obstacle or hurdle later on. It is so common that people wait too long and then feel awkward regarding embarking onto major surgery that will hospitalize them even further for a period of a couple of months, during the time it takes for the tendon transfers to heal. One of the most important things with modern reconstructive hand surgery is to be sure that you have time and guidance to exercise your hand after the surgery. There is no point, it is useless to do this if you go back to your home in a remote town and just “hang around” and think that time will help you. You have to be dedicated and in the right mood in order to get the best results. In other words, if you don’t have full hand function after spinal cord injury, never, ever, question whether you should embark on reconstructive hand surgery. It is a huge waste not to do this. Good luck! "

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