Introduction
Tendon transfer is taking a functional but expendable muscle and tendon unit and using it to reconstruct another more important function that has been lost.
Indications
Tendon transfer can address many functional problems in the hand and wrist. Common indications are for wrist and finger extension after a radial nerve injury, or for thumb extension after an extensor tendon rupture caused by a wrist fracture.
Preoperative Instructions
Tendon transfer surgery is usually performed as day surgery under general anaesthetic. Anticoagulant medication should be stopped in consultation with your doctor.
Procedure
The donor tendon and recipient (non-functional) tendon are dissected out and divided, oven via different incisions depending on the transfer. A tunnel is sometimes created to allow the tendon ends to meet. The ends of the transferred tendons are woven together at the appropriate tension and secured with strong sutures.
Postoperative Instructions
A plaster is placed on the hand for the first week, after which splint is placed by the hand therapists to protect the repairs. Some movement is encouraged to avoid stiffness and at around 6-8 weeks full movement and strengthening are commenced.
Risks
Although rare, tendon transfers can rupture, resulting in the loss of the reconstructed muscle function.
Treatment Alternatives
Ongoing physio with custom made splints can be an alternative to some kinds of tendon transfer.