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What is tendon transfer surgery?

There are more than 40 muscles below the elbow, and each muscle has its own specific function. When a muscle is injured or paralyzed and no longer functions, tendon transfer surgery may be needed in order to restore motor skills and function in the hand. After the surgery, the patient should regain the ability to straighten and bend the elbow and wrist, and the ability to grip with the fingers and hand.

Why it's done

Tendon transfer surgery can be used to treat a variety of conditions, including:

  • Nerve injuries—Sometimes muscle function is lost due to a nerve injury. When a nerve is injured and incapable of functioning, it fails to send signals to certain muscles. Those muscles are therefore paralyzed and lose all functionality.
  • Ruptured or lacerated tendons or muscles—Rheumatoid arthritis and fractures are two common conditions that cause a tendon to rupture. Lacerations are caused by direct injury, such as a cut from a piece of broken glass. In this case, if direct repair cannot be done, tendon transfer surgery becomes necessary.
  • Nervous system disorders—Certain disorders of the nervous system such as cerebral palsy, spinal muscle atrophy and traumatic brain injury can hinder muscle function by preventing normal nerve signals from being sent to the corresponding muscle.
  • Birth defects – In some instances, babies are born without certain muscle functions. Hypoplastic (underdeveloped) thumbs and birth brachial plexopathy (nerve problems, with paralysis) are examples of congenital conditions that can be repaired with tendon transfer surgery.

What to expect

The hand surgeon replaces or connects a diseased or inactive tendon with a healthy tendon. During tendon transfer surgery, the origin of the muscle and its own nerve and blood supply are all left in place. The tendon is detached from its bone and re-sewn onto a different area. It can either be sewn onto a different bone or onto a different tendon which needs motor function. When the muscle contracts, a new action will be produced, depending on where the tendon has been inserted.

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