This text summarises all knowledge available on the management of the upper limb in tetraplegics. It gives full coverage of the process of patient evaluation, outlines spinal cord injuries in relation to the upper limb, and reviews both surgical and non-surgical rehabilitation in every type of patient, from the very weak to the strong. For every clinical situation the absolute indications and contraindications, operative detail, post-operative management, expected outcome and common complications are reviewed so that the clinician is able to make a clear decision as to the best course of action in each type of patient.