Tuesday , September 27 2022

The limb paralysis can move your hands again.


Thanks to the new method, the limb paralysis patient can move his arms and hands again. These surgeries can only be performed by about 30 surgeons worldwide. Jan Fridén of the Swiss Paraplegic Center in Nottwil is one of them.

Nils Jost

Jan Fridén, a hand surgeon, has already performed surgery on more than 1,200 patients with limb paralysis, so he can move his hand partially. (Photo: Nadia Schärli (Nottwil, October 30, 2018))

Jan Fridén, a hand surgeon, has already performed surgery on more than 1,200 patients with limb paralysis, so he can move his hand partially. (Photo: Nadia Schärli (Nottwil, October 30, 2018))

Jan Fridén is someone they are looking for. He does not have time to interview. So the appointment is predetermined a few weeks in advance. It is therefore amazing how a hand surgeon appears at our meetings in T-shirts, casual trainers pants and finches at Nottwil's Swiss Paraplegic Center (SPZ). Friden has charisma and looks relaxed, but his eyes are concentrated. He had just been at the surgery table, but his colleagues in the orphan and tetraplegic surgery are now continuing surgery.

Friden speaks good German and even some Swiss German, but we speak in English. So he can better explain how limb paralysis patients can move their arms and hands. And one in five people can explain why they refused such surgery.

Jan Fridén, you are nominally considered tetraplegic and have performed about 1,200 hand reconstructions in patients with spinal cord injuries. Although this methodology has been known since the 1970s, approximately 30 surgeons around the world can do this.

At that time, I did not pay much attention to this method. About ten years ago, neurotransmission technology resumed and has since developed constantly. My technique is unique because I can do it with a single operation so that the patient can open and close the finger without using the original muscle or tendon. This is done by placing the muscles or nerves in different positions.

Which patient are you and your six-person team taking care of at SPZ?

Not only spinal cord injury, but also brain damage. People with limited or no arms and hands. Whether due to an accident, illness or infection, we can restore all or some of the functions of the hand. There are three types of surgery: we reassemble muscle, tendon or nerve alternately.

"If you can move your hands again, you will regain a tremendous quality of life."

How does it work?

The method we use depends on the degree of spinal cord injury. For example, if the paralysis is relatively severe, it is a problem that muscles are delivered. Move the undamaged muscle to a place where you can perform a central function, such as bending your fingers from your upper or lower arms, or opening and closing your fist.

In other words, did the limb paralysis muscles paralyze, but still remain intact?

Muscles are fully functional. They only need one impulse. For this we block the intact nerve and insert it into the nerve that does not function. Nerves grow back – up to 1 millimeter per day! We find that the growing nerve is the target muscle, and in turn enables the hand function mentioned.

The interview was interrupted. Freedon's cell phone rings. "This is the operating room, I have to go there quickly," he says. Later on he gives some advice and he focuses on conversation again. "Should I go back to the operating room in 30 minutes?"

How long does surgery take?

5-6 hours. But it is not enough.

What are you talking about?

After such complicated surgery, the patient must stay in the SPZ for up to 3 months and spend several months in the outpatient setting. Speaking: away from home to hospital. This is the main reason why one in five refuses to work.

How long does the rehabilitation process take?

The patient must learn all the functions of his / her arms and hands again. It takes up to 12 months and is a tough job. Even simple actions in daily life are extremely complex. For example, to lift a glass, first stretch your arms, then stretch your hands, hold the glass with sufficient pressure, and finally turn the glass off again. This requires a lot of time and balance.

"If someone does not want to face the learning process, surgery will not help."

Is your method always successful?

If someone does not face the learning process, the OP will not help. But before each intervention we create tests and prognoses for the functions that the patient can recover. 100% recovery of technology is almost impossible, but in all cases we will achieve improvement.

Is that what you mean?

If you can move your hands again, you will regain a tremendous quality of life. You can even shake or hug somebody's hand or even communicate with your phone. Patients can also move the wheelchair. Such interventions change the whole life of the patient and its surroundings. It motivates me to go to work every day.

Do you pay insurance premiums?

Yes, but we need to tell the insurer exactly what technology the patient will recover. However, long-term health care is only mitigated if someone can get dressed again.

According to recent media reports, ETH treatment can cause paraplegia to recur. Is that even possible?

no. The legs carry the entire weight. At present, we can not reactivate many muscle masses with muscle or neurotransmitter technology.

Nevertheless, modern medicine seems to have no limit. How far do you go? You also play ethical in your work
The Role of Principles?

sure. On the contrary, I wonder how modern people can approach as many people as possible. They are only available in about 15 countries around the world. It would be better if it was much better.

You have been in SPZ since 2011. Previously you led the Tetra Hand Surgery Center at the University Hospital in Gothenburg. Why did you change Nottwil?

The Competence Center of Nottwil's Department of Surgery is unique in Europe. Our team consists of physiotherapists and occupational therapists, researchers and doctoral students as well as surgeons.

After 60 minutes, the interview is over. Fridén is only 5 minutes away for a photo session. "I have to go to the operating room."

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