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A tendon transplant, also called tendon transfer surgery, helps to restore hand functions lost to disease or injury. During surgery, orthopedic surgeons "transfer" or reassign part of the injured muscle or tendon from the paralyzed hand, elbow, or arm to an extra, working tendon. Physical therapy following tendon transplant recovery often restores the arm, elbow, and hand back to normal.
Tendons normally function as "cords" that attach muscles and bones together within the arms, elbows, and hands. A tendon interacts with a joint and transmits signals from the muscle to the joint, thereby enabling movement. Tendon transplant surgery may be necessary because of nerve damage that results in paralysis of the arms and hands. The transplant attempts to correct proper muscle and joint functioning. Some injuries that require a tendon transfer affect the radial, median, and ulnar nerves, and the spinal cord.
Tendon and muscle injuries caused by fractures, or conditions like rheumatoid arthritis, sometimes require tendon transfer surgery. Muscle and tendon dysfunctions caused by nervous system disorders also usually require a tendon transplant. This kind of injury blocks nerve signals from moving to the muscle, therefore causing restricted arm and hand movement. Disorders such as traumatic brain injuries, spinal muscle atrophy, cerebral palsy, and stroke are often associated with tendon transfer surgery because they usually affect joint movement.
Surgeons use a grafting technique to relocate tendons and tissues of working muscles to the area of the paralyzed nerve or muscle. The transfer allows the working muscle to perform the functions that the paralyzed tendon has lost. Some benefits of tendon transplant surgery include improved hand and finger grip, the increased ability to flex the wrist, and the improved capability of bending and extending the elbow. According to medical sources, tendon transplant surgery can last for up to six hours.
Some risks associated with a tendon transplant include scarring at the incision site, which may lead to infection if not properly treated. Medical resources also indicate that postoperative respiratory problems may result because of the length of the transplant surgery. Since doctors work with the patient's tissues, they must also be careful to prevent the patient from developing latex allergies.
Depending on the patient's overall condition, the joint usually requires one or two months of healing time following the tendon transfer surgery. Doctors recommend wearing a splint or cast to protect the arm, elbow, or hand during the healing process. Physical therapy helps the patient learn the functions of the transferred tendon. After the recovery period, the orthopedic doctor generally recommends practice exercises to improve muscle strength and movement within the arm, elbow, and hand.