Réanimation des paralysies du membre supérieur:
French surgeons have long used the word "réanimation" in reference to their efforts to reconstructed the paralyzed upper extremity. In this context, réanimation refers to the restoration of "life" or movement to an otherwise still or lifeless upper extremity.

Purpose:
This clinic focuses on the rehabilitation and surgical reconstruction of the paralyzed or spastic upper extremity of any etiology.

Patient Population:
This clinic serves adult patient populations with the following problems:

1. brachial plexus injuries, both acute and chronic
2. complex peripheral nerve problems, both acute and chronic
3. cerebral vascular accident (ie. Stroke)
4. cerebral palsy
5. spinal cord injuries
6. muscle loss due to trauma or cancer
7. neuromuscular problems
8. mutilating hand injuries
9. amputations

Assessment:

All patients in this clinic will undergo the following during their initial assessment:
1. complete history
2. review of all pertinent past medical information
3. examination of the upper extremity
4. classification of upper extremity paralysis
5. SF-36 (Quality of life self-assessment questionnaire)
6. DASH (Upper extremity disability questionnaire)
7. Photographs and or video taping of the upper extremity

Investigations:
Further information regarding the status of the dysfunctional upper extremity may be required. As such, some patients may require additional investigations. These may include:

1. Reanimation Abilities Evaluation: A functional assessment of the upper extremity performed by a hand therapist at the Toronto Western Hospital.
2. Sensory Evaluation: A detailed examination of the sensory function of the upper extremity performed by a hand therapist at the Toronto Western Hospital.
3. EMG-Nerve Conduction Studies: An electrophysiological test assessing nerve and muscle function of the upper extremity performed by a neurologist at the Toronto Western Hospital.
4. Plain X-rays
5. Bone Scan
6. CT Scan
7. MRI
8. Functional MRI
9. Arteriogram

Decision to proceed:

Not all patients with upper extremity paralysis or dysfunction are candidates for rehabilitation or surgery. The decision to proceed with rehabilitation or surgery is made only after all information is gathered and analyzed. Then in consultation with the surgeon and therapist and patient, the best reconstructive approach is decided upon.

Commitment

The surgeon and therapists are committed to improving the functional outcome of any rehabilitation or surgery to the upper extremity and to the patient as a whole.

Surgical Procedures Available to the Patient with a Neuromuscular Problem of the Upper Extremity