Who is a candidate for a Tendon Transfer?
In patients with long-standing nerve paralysis or in those patients with incomplete muscle recovery, simply fixing the nerve is no longer an option. This is because by 12-18 months, the nerve permanently loses its connection to the muscle that it is controlling. After then, even if the injured nerve is fixed, it won’t be able to tell the muscle to contract. In these situations, a Tendon Transfer may be a useful treatment option. For this to be successful, there must be an available source of strong donor tendons close to the area in need of strengthening.
What is a Tendon Transfer?
In this procedure, an expendable tendon is selected from a healthy but less important muscle group. The donor tendon is released off of its bone insertion and reconnected to a weak tendon that is more important to shoulder, elbow, or hand function. The transferred tendon now has a new function to learn to perform. Examples include transferring a shoulder internal rotator muscle (latissimus) to restore shoulder external rotation or a wrist flexor to restore finger extension.
How long is the recovery for a Tendon Transfer?
Tendon Transfer surgery generally takes a couple of hours and can be performed under general or wide awake local anesthesia. After the completion of surgery, the surgical area is protected in a half cast, termed a splint. Following a 1-2-hour recovery period, patients are discharged home the same day on Tylenol, Motrin, and a short course of narcotics. Elevation is recommended to push out the swelling and prevent joint stiffness. One week after surgery, the operative splint if exchanged for a removable splint and patients can get the incision wet. Patients will be followed closely by occupational therapists, who will supervise an active motion protocol and teach patients how to activate the transferred tendon to bring about the desired motion.
Which conditions can be treated with a Tendon Transfer?
Tendon Transfer procedures are useful in treating;
- Brachial Plexus Palsy
- chronic forms of Carpal Tunnel Syndrome
- Cubital Tunnel Syndrome
- some forms of foot drop from Peroneal Nerve Entrapment