Nine tetraplegic patients with C5 or C6 level spinal cord lesions had the Freehand System, an eight channel Functional Electrical Stimulation device, implanted to allow of hand opening and grasp. This paper describes the surgical implementation of the system and the challenges encountered. Seven of the subjects are currently daily users of the device. One subject is unable to use the system due to disruption of bowel function when the system is used. A second subject suffered a lesion of the posterior interosseous nerve, but this was not thought to be related to system use. Additionally, one subject exhibited symptoms of autonomic dysreflexia, which were alleviated by reduction of the strength of the stimulus. Despite such problems, the Freehand system can significantly improve the functional ability of C5 and C6 lesion tetraplegics.
Copyright 2001 The British Society for Surgery of the Hand.