Thursday, May 13, 2010

Rochus’ story

Rochus Gelsinger is a role model. The 62-year-old retired craftsman sustained a severe paralysis that particularly affected his right upper extremity during a car accident in 1972. It left his right hand almost useless. “Nothing can be done about this”, he was told, however, he worked full-time until his retirement using his right hand as a counterbalance, but else only could hold a paper as his grip was extremely weak with flail fingers and a floppy thumb. In September 2009, almost 40 years after his accident, he was operated by Prof. Fridén and Andreas Gohritz at the Clinic of Plastic, Hand and Reconstructive Surgery (chaired by Prof. Peter Vogt), Hannover Germany. Mr Gelsinger underwent an operation called ABCDEFG (Advanced Balanced Combined Digital Extension Flexion Grip) reconstruction to restore key pinch between thumb and index finger, thumb stability, opening and closure of the fingers and wrist alignment. In order to increase the awareness of treatment options for this type of functional deficits, surgery was real-time broadcasted as part of an International Instructiomal course at the German Society of Plastic, Reconstructive and Aesthetic Surgeons. After the operation, Rochus trained very diligently under supervision of his therapist, but also on his own at home and excercised his new hand functions. Over the following months, he has regained a strong and stable thumb-to-index pinch with strength of more than 2 kg, a firm global finger grip (grasp) to hold larger objects and a controllable hand opening. Rochus’ example shows that tendon transfer offers the chance to restore hand function lost by paralysis even decades after the original injury. This is possible as tendon transfer relies on remaining function of intact muscles whose tendons are simply reattached to a different point of insertion to restore essential abilities like wrist extension, pinch or grasp. Therefore, no arbitrary limit of delay or patient age exists for tendon transfer - opposed to nerve reconstruction for example, which is only reasonable within about 2 years as the denervated muscle becomes fibrotic and unable to contract by nerve stimulation. Rochus is very happy with his new skills, such as eating, drinking, cooking, writing, grooming, holding large objects and a firm manly hand-shake with other people - using his formerly almost inoperable and hidden right hand. He is still exercising everyday to take literally more new things into his own hand. “I want to become even better …” Rochus is a true role model – it is never too late to improve.