Grand Rounds at University of California San Diego Orthopaedics recently covered the topic tetraplegia hand surgery. Prof. Jan Fridén, Univ. of Gothenburg, Sweden reported the Swedish experience of candidate selection process for surgery, operative techniques, postop. training and outcomes. Discussions addressed differences between the US and Sweden in terms of epidemiology of cervical spinal cord, treatment strategies and health insurance issues. Everybody agreed upon the importance of increasing the awareness of surgical treatment among persons with tetraplegia as well as physiatrists. Also, at the board meeting of of NMSRC (National Muscle Skeletal Research Center), the need for strengthening the bonds between surgery and rehabilitation as well as translational research efforts must be a prioritized immediately.