Principles of Tendon Transfer and Tendon Transfer for Radial Nerve Palsy at Midarm
DNB Orthopaedics • May 2024 • Paper IV • 10 Marks
Introduction
Tendon transfer is a reconstructive procedure in which the tendon of a functioning muscle is detached from its normal insertion and reattached to another tendon or bone so that its muscle power is redirected to restore a lost function.
It is commonly used when recovery of a paralysed muscle is absent or unlikely, particularly after peripheral nerve injury, poliomyelitis, cerebral palsy, spinal cord disorders and selected traumatic musculotendinous losses.
A successful tendon transfer requires four things: a functioning donor, a supple recipient joint, an efficient line of pull and postoperative motor re-education.
Definition
Tendon transfer is the surgical redirection of a functioning musculotendinous unit from its normal insertion to a new insertion in order to substitute for a lost motor function.
It must be distinguished from:
- Tendon graft — a non-contractile graft used to bridge a tendon defect.
- Tendon repair — direct repair of an injured tendon.
- Nerve transfer — redirection of an expendable motor nerve branch to restore innervation.
Indications for Tendon Transfer
- Irreversible peripheral nerve palsy
- Failed nerve repair or nerve grafting
- Late…