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In the lower groups according to the International Classification (IC groups 0-1) this can only be done by means of tenodesis.
Many times, the biceps tendon is damaged with rotator cuff tears and may also require biceps tenodesis surgery at the same time.
In the 1950s, understanding of the tenodesis effect influenced the development of surgical techniques such as the static flexor tenodesis.
Wrist-related tenodesis effect means that wrist flexion passively opens the hand and wrist extension passively closes the hand.
On June 23, 2008, Schilling underwent biceps tenodesis surgery, during which a small undersurface tear on the rotator cuff was discovered and stitched, and a separation of the labrum was repaired.
(see pictures below) Wrist-related tenodesis effect is the key point of any functional surgery in a paralyzed hand, therefore active wrist extension is required and reconstruction of this active wrist extension is of utmost importance for the tetraplegic hand.