TENDON TRANSFERS

Tendon transfer surgery is, after the loss of hand functions due to various reasons, shifting a working tendon from its original attachment to a new one in order to restore the action that has been lost.

Many different conditions can be treated by tendon transfer surgery.

When an injured nerve is not treated after a nerve injury or when no improvement is gained despite the treatment, the loss of muscle function occurs as the nerve no longer sends signals to certain muscles. Tendon transfer surgery is performed to restore the lost functions. Tendon transfer surgery is applied mostly for brachial plexus, radial nerve, ulnar nerve, or median nerve injury.

 

  • Tendon transfers are performed following the tendon ruptures that are occurred after the rheumatic diseases. Tendon ruptures may occur following the fractures.
  • Tendon transfers are performed when untreated tendon injuries occur or when extreme cohesiveness to tissues around developed during recovery despite being treated and performed in conditions when no recovery can be provided by other techniques. 
  • Tendon transfer surgery may also be needed due to imbalance in hand function following muscle function disorders resulted from various diseases occurred in the brain. Tendon transfers are performed in the treatment of Cerebral palsy (disorders happened following brain injuries occurred during birth or afterwards), stroke, traumatic brain injuries, muscle atrophy following channel incarceration between vertebrae.

Over 40 tendons below the elbow function to provide hand movements. 9 muscles provide movements of the thumb. Each tendon is attached to different locations of the hand enabling the movement. The beginning location of muscle, the structure of vessel and nerve are protected during the tendon transfer. Only the tendon attached to this muscle is removed from the connecting point and transferred into a new tendon having another duty. Thus, when the muscle is contracted, not the usual one, but the movement supposed to be done by the tendon transferred is provided. Following the tendon transfer, 4 weeks of plaster treatment is continued. Physical therapy is strictly required after the plaster. The brain is needed to be adapted to do another movement that is not expected to be done by a certain muscle, which the Physical therapist is needed to give training on.  Besides, patients exercise before and after the transfer to obtain enough muscle power. If the rules are followed, tendon transfers provide very successful and effective results to restore the hand functions.

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