Reconstruction of the upper extremity in the child with tetraplegia

According to Howard H. Steel, the orthopedic surgeon who first recognized the need for special care for children with spinal cord injury (SCI), and who persuaded Shriners Hospitals to establish specialized programs for these children over 20 years ago, no field of the health sciences is the statement "a child is not a small adult" more apropos than in the arena of trauma to the spinal cord. Children and adolescents with tetraplegia differ in many ways from adults with the disease. The dissimilarities that influence the outcome of surgical reconstruction of the upper extremity are the focus of this article.