What is tendon transfer surgery?
Tendon transfer surgery seeks to restore lost function of the hand due to conditions such as rheumatoid arthritis.
Tendon transfer surgery is a type of hand surgery that is performed to improve the lost function of the hand. In this surgery, a functioning tendon is shifted from its original attachment to another site in the hand for restoring the lost action.
If the nerve supplying the muscle is damaged beyond repair, the action of the muscle is lost. Tendon transfer from a functional site may be performed in such cases to restore the lost function.
A tendon is a cord-like fibrous band that attaches a muscle to a bone to aid movement during muscle action.
The hand has two groups of tendons:
- Extensor tendons: They run from the forearm across the back of the hand to the fingers and thumb, allowing you to straighten your fingers and thumb.
- Flexor tendons: They travel from the forearm through the wrist and across the palm, allowing you to bend your fingers.
- A tendon transfer surgery may be performed to repair damage to both these groups of tendons.
Who needs a tendon transfer surgery?
You may require a tendon transfer surgery to restore your lost function of muscles or tendons due to the following:
- Nerve injury (torn, cut, or stretched nerve)
- Muscle injury
- Neuromuscular disorder (such as cerebral palsy, stroke, traumatic brain injuries, and spinal muscle atrophy)
- Birth defect (babies born without certain muscle functions)
- Rheumatoid arthritis (a long-term inflammatory disease affecting various parts of the body including the muscles, joints, and bones)
How does a tendon transfer work?
The hand has various muscles attached to the bone by tendons. A muscle may lose its functions because of an injury; for example, if the wrist gets broken during an accident, the movement of some muscles of the hand may be hampered.
A tendon transfer surgery restores the lost function by replacing non-working muscles and tendons with working ones. The surgery may be performed under mild sedation or under general anesthesia (you sleep during the procedure) depending on the severity of the injury and the extent of repair required.
During this surgery, the surgeon makes a surgical cut (incision) and harvests the tendon of an extra muscle that is moved from another place and stitches it to the tendon of the non-working muscle. Thus, the muscle attached to the transferred tendon is now a functional muscle. More than one tendon transfers may be required to repair some injuries.
The newly transferred tendon is protected by a cast or splint until the tendon heals to its new position in one to two months. During this period, the person must undergo physical therapy to attain optimal function and quick recovery.
What are the risks of tendon transfer surgery?
The risks of tendon transfer surgery are as follows:
- Infection
- Pain
- Repair failure
- Tendon adhesion (tendons become stuck to the surrounding tissue and lose their range of movement)
- Hand deformity
- Bleeding
- Injury to nearby nerves, tendons or blood vessels
- Hand stiffness
- Hand weakness
- Swelling
- Rupture of the transferred tendon and the need for another corrective surgery