Which patient would most benefit from a wrist-driven tenodesis orthosis?

Which patient would most benefit from a wrist-driven tenodesis orthosis?

• A. Used for C4 SCI with intact finger flexors
• B. Used for C6 SCI in the absence of active finger flexion
• C. Used for carpal tunnel syndrome
• D. Used for shoulder dislocation

Answer: (B)

The wrist-driven tenodesis orthosis uses the tenodesis effect: when the wrist is extended, the fingers passively flex, enabling a functional grasp even when finger flexors are weak or paralyzed. This works best when wrist extension is preserved and finger flexion is lost, such as after a high-level spinal cord injury. In a C6 SCI, wrist extension is typically intact (via extensor carpi radialis longus/brevis) while active finger flexion is weak or absent. The orthosis lets the patient extend the wrist to produce finger flexion and grasp objects, providing meaningful hand function without active finger flexion. The other scenarios don’t fit as well: a person with intact finger flexors wouldn’t need this device, a wrist extension–poor injury wouldn’t allow the tenodesis mechanism, and carpal tunnel or shoulder problems aren’t addressed by this orthosis.

The wrist-driven tenodesis orthosis uses the tenodesis effect: when the wrist is extended, the fingers passively flex, enabling a functional grasp even when finger flexors are weak or paralyzed. This works best when wrist extension is preserved and finger flexion is lost, such as after a high-level spinal cord injury.

In a C6 SCI, wrist extension is typically intact (via extensor carpi radialis longus/brevis) while active finger flexion is weak or absent. The orthosis lets the patient extend the wrist to produce finger flexion and grasp objects, providing meaningful hand function without active finger flexion.

The other scenarios don’t fit as well: a person with intact finger flexors wouldn’t need this device, a wrist extension–poor injury wouldn’t allow the tenodesis mechanism, and carpal tunnel or shoulder problems aren’t addressed by this orthosis.