IntroductionTendon transfers are used to restore function after an injury or medical condition has compromised function in the hand. Loss of function in the hand can occur because of several types of problems including paralysis from nerve injury, tendon loss, and muscle loss. Tendon transfer surgery relocates a healthy tendon to restore the movement in an affected joint. Surgery is followed by a period of splinting and hand therapy rehabilitation.
The extensor tendons begin near your elbow and continue to the back side of your fingers and thumb. As the extensor tendons reach your fingers, they become flat and thin. The extensor tendons attach to your phalanges via a complex system. The extensor tendons allow your fingers and thumbs to straighten and perform fine coordinated movements.
Certain criteria must be met before a tendon transfer can take place. The joints must be flexible. Stiff joints may be freed with hand therapy or surgically released prior to tendon transfer. For optimal use, the affected portion of the hand should have sensation. Nerve repair surgery may sometimes be able to restore sensation prior the tendon transfer.
Only healthy tendons with good functioning (strength and excursion) and good blood supply are considered for transfer. A tendon should be taken from an area where remaining tendons can perform its function. A tendon is usually transferred to restore only one movement or function. It usually only crosses one joint.
After you are anesthetized, your surgeon will make an incision to access the tendon(s) to be transferred and the area where the tendon will be attached. The selected tendon will be prepared. In some cases, tendons may be made longer by grafting additional tendon tissue. The tendon is appropriately routed to the attachment site. The more direct the line of pull, the better. Your surgeon will make a preliminary attachment and check the tension and function of the transferred tendon. The transferred tendon is secured with stitches using a weave procedure.
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The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on February 16, 2022. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.