In a report on hand tendon transfers, a group of physicians explained how this amazing treatment can be used to, “Create major improvement in the function of the extremity”, and that it was able to restore function in a new location. (Baumeister, et al, 2015).
Obviously, this makes tendon transfer surgery sound somewhat miraculous, and to those who need it and receive it, it truly can be. It is a surgical procedure in which a functional section of tendon is moved from its normal, natural position and attached to a new location in order to help restore function to that particular area.
It is as complex as it sounds and yet hand surgeons rely upon it for a long list of patients:
- Babies born without specific muscle functions can benefit from tendon transfer surgeries.
- Patients with nerve injury may benefit from the ability to use muscles disabled by the damaged nerves.
- Muscles that have been lacerated or ruptured (and which are beyond repair) can benefit from the procedure.
- Tendons damaged beyond repair can be replaced with a transfer.
- Patients with nervous system disorders may lose muscle function, and yet tendon transfers may help them to regain some use of certain hand functions. This includes patients with traumatic brain injuries and stroke.
Clearly, this is a very useful procedure that can be a far more amenable option than many alternatives. For instance, the tendon transfer surgery can easily be used instead of surgery attempting to repair a nerve or muscle.
How a Tendon Transfer Surgery Works
It is difficult to summarize such a complex procedure, but to keep it a simple as possible: when a hand surgeon is going to use a tendon transfer, they begin by altering the point of contact between the tendon and the bone on which it originally resided. In its natural place, the tendon would always connect to a group of muscles that are, in turn, connected to their point of origin. In tendon transfer, the muscles are left alone, and it is the end point or terminus of the tendon that is altered.
The new connection point is chosen in order to create a very specific outcome. This is because the tendon can be attached to a different bone or tendon. This will allow the muscles to “fire” as normal, but their functions will now produce a different action or outcome.
This is why some stroke patients who have limited movement in the hands can have the most important functions, the pinching function, restored through a tendon transfer. This allows whatever muscle and nerve function remains to provide the pincer fingers with the ability to grip and move at will.
Your hand doctor will be able to determine if a tendon transfer is the best surgical solution for your needs. You will need to heal for a period of two months or more, get therapy to ensure the hand functions properly, and follow a rigid course of rehabilitation to get the best outcomes. However, the prognosis for most patients is usually good, and this procedure can provide you with a return of function that may have been lost.
Baumeister, Steffen, et al. Hand Tendon Transfers. 2015. http://emedicine.medscape.com/article/1286712-overview