Tendon Transfer

What is tendon transfer surgery?

Tendon transfer surgery is a surgery to restore the lost functions of the hand by shifting functioning tendon from its initial attachment to the new one.

Indications for tendon transfer surgery

• Tendon transfer surgery is done to restore certain muscle functions that are lost as a result of nerve injury. Some of the common nerve injuries that can be treated with tendon transfer surgery include spinal cord, radial nerve, ulnar nerve, or median nerve injury.
• Muscle and tendon injuries such as tendon ruptures due to rheumatoid arthritis or fractures, irreparable muscle and tendon lacerations.
• Nervous system disorders such as cerebral palsy, stroke, traumatic brain injuries and spinal muscle atrophy.
• Congenital conditions such as hypoplastic thumbs and birth brachial plexopathy (paralysed nerves) in which certain muscle functions are absent can be treated with tendon transfer surgery.

Principle of tendon transfers

During a tendon transfer surgical procedure, the muscle's origin, its nerve supply and blood supply are kept intact but the tendon is detached from its place of insertion (attachment) on the bone and sutured back into a different bone or tendon. After the tendon is transferred, when a muscle contracts it will produce a new action depending on its place of insertion.

Post-operative care after a tendon transfer

Usually, a tendon transfer surgery will require a period of 1-2 months to heal completely. During this time, a splint or cast will be given following which you will be taught about the new tendon function. After the tendon transfer has healed, your surgeon may recommend exercises to strengthen the muscle. It is important to take care that you do not start movements too early as it may cause rupture of the tendon transfer and at the same time do not delay the movements. Delayed movement can lead to scarring of the tendon and stiffness.