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Secondary Procedures for Failed Tendon Transfers

  • Jennifer Moriatis WolfEmail author
Chapter

Abstract

Fortunately, in many cases tendon transfers work as planned. However, there can be instances where the initial tendon transfer fails for various reasons. In these cases, the surgeon may be faced with a limited number of options as far as other potential tendon transfers, given the lack of donor tendons already utilized in the previous procedures. Some creative thinking and understanding of the various anatomical considerations will reveal some possibilities. These include harvesting other muscle tendon donor units, soft tissue tensioning procedures as well as joint fusion. These techniques can be considered individually or in combination to help increase the patient’s functional abilities of the extremity. These are challenging cases that frequently force the patient and surgeon to engage in some compromises in order to maximize the potential function and this should be explained to the patient in advance. However, in many cases the patients are able to reengage the extremity in a functional fashion. This chapter looks at those options and these challenging reoperative situations.

Keywords

Failed Tendon Transfers Flexor Extensor Fusion 

References

  1. 1.
    Brand PW. Tendon transfers for median and ulnar nerve paralysis. Orthop Clin North Am. 1970;1:447–54.PubMedGoogle Scholar
  2. 2.
    Tsuge K. Tendon transfers for radial nerve palsy. Aust N Z J Surg. 1980;50:267–72.PubMedCrossRefGoogle Scholar
  3. 3.
    Chuinard RG, Boyes JH, Stark HH, Ashworth CR. Tendon transfers for radial nerve palsy: use of superficialis tendons for digital extension. J Hand Surg Am. 1978;3:560–70.PubMedGoogle Scholar
  4. 4.
    De Smet L, Schollen W, Degreef I. In vitro biomechanical study to compare the double-loop technique with the Pulvertaft weave for tendon anastomosis. Scand J Plast Reconstr Surg Hand Surg. 2008;42:305–7.PubMedCrossRefGoogle Scholar
  5. 5.
    Burkhalter WE. Restoration of power grip in ulnar nerve paralysis. Orthop Clin North Am. 1974;5:289–303.PubMedGoogle Scholar
  6. 6.
    Riordan DC. Tendon transfers in hand surgery. J Hand Surg Am. 1983;8:748–53.PubMedGoogle Scholar
  7. 7.
    Bunnell S. Tendon Transfers. In: Boyes JH, editor. Bunnell’s Surgery of the Hand. 5th ed. Philadelphia: JB Lippincott; 1970. pp. 409–430.Google Scholar
  8. 8.
    Zancolli EA. Claw-hand caused by paralysis of the intrinsic muscles: a simple surgical procedure for its correction. J Bone Joint Surg Am. 1957;39-A:1076–80.PubMedGoogle Scholar
  9. 9.
    Anderson GA, Lee V, Sundararaj GD. Extensor indicis proprius opponensplasty. J Hand Surg Br. 1991;16:334–8.PubMedGoogle Scholar
  10. 10.
    Burkhalter W, Christensen RC, Brown P. Extensor indicis proprius opponensplasty. J Bone Joint Surg Am. 1973;55:725–32.PubMedGoogle Scholar
  11. 11.
    Sakellarides HT. Modified pulley for opponents tendon transfer. J Bone Joint Surg Am. 1970;52:178–9.PubMedGoogle Scholar
  12. 12.
    Kozin SH. Tendon transfers for radial and median nerve palsies. J Hand Ther. 2005;18:208–15.PubMedCrossRefGoogle Scholar
  13. 13.
    Jensen EG. Restoration of opposition of the thumb. Hand. 1978;10:161–7.PubMedCrossRefGoogle Scholar
  14. 14.
    Riordan DC. Tendon transfers for nerve paralysis of the hand and wrist. Curr Pract Orthop Surg. 1964;23:17–40.PubMedGoogle Scholar
  15. 15.
    Papp SR, Athwal GS, Pichora DR. The rheumatoid wrist. J Am Acad Orthop Surg. 2006;14:65–77.PubMedGoogle Scholar
  16. 16.
    Hayden RJ, Jebson PJ. Wrist arthrodesis. Hand Clin. 2005;21:631–40.PubMedCrossRefGoogle Scholar
  17. 17.
    Omer GE, Capen DA. Proximal row carpectomy with muscle transfers for spastic paralysis. J Hand Surg Am. 1976;1:197–204.PubMedGoogle Scholar
  18. 18.
    Jebson PJ, Adams BD. Wrist arthrodesis: review of current technique. J Am Acad Orthop Surg. 2001;9:53–60.PubMedGoogle Scholar
  19. 19.
    Viegas SF, Rimoldi R, Patterson R. Modified technique of intramedullary fixation for wrist arthrodesis. J Hand Surg Am. 1989;14:618–23.PubMedCrossRefGoogle Scholar
  20. 20.
    Berger RA, Bishop AT, Bettinger PC. New dorsal capsulotomy for the surgical exposure of the wrist. Ann Plast Surg. 1995;35:54–9.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryUniversity of Connecticut Health Center, New England Musculoskeletal InstituteFarmingtonUSA

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