- Radiculopathy:
- pts with a C6 radiculopathy should cause pain in the neck, shoulder, lateral arm, radial forearm, dorsum of hand, and tips of thumb, index, and long finger;
- distribution of pain is less extensive and more proximal, whereas paresthesia's predominate distally;
- in some individuals, a C6 lesion will manifest as a depressed or absent
biceps reflex;
- in others, an abnormal
brachioradialis or wrist extensor reflex can be found;
- C6 root lesions should be distinguished from lesions of
brachial plexus;
- elbow flexion will be weak, and the patient will be unable to supinate the forearm against resistance with the elbow held in extension;
- C6 Quadriplegic Considerations:
(
care of the spine injured patient)
- pts w/ C-6 functional level can become independent because wrist extensor muscle function is still intact.
- pts may engage in independent living and perform independent sliding board transfers from bed to chair
and will be able to propel a manual wheelchair w/ quadriplegic pegs on wheel rim;
- pts should be able to perform self hygiene and feeding;
- in C6 lesions, radial wrist extension & varying degrees of
triceps (C6-8) function is preserved;
- major concern in these patients is prevention of flexion contractures at elbow to the unopposed action of the flexor muscles;
-
steindler flexorplasty :
- w/ C6 level paralysis
brachioradialis & the
ECRB /
ECRL are only muscles functioning at the forearm and wrist;
- consider transfer of
ECRL to
FDP
&
BR
to
FPL ;
- consider transfer of
biceps
to olecranon process inorder to assist extension of the elbow;
-
splints for C6 level;
- pts require a wrist driven flexor hinge hand splint for prehension;
- splints for C-6 escape:
- proximal stability present;
- loss of grasp
- good candidate for flexor hinge hand splint;
- ref:
The Influence of Elbow Position on the Range of Motion of the Wrist Following Transfer of the Brachioradialis to the Extensor Carpi Radialis Brevis Tendon.
