Secondary Procedures for Failed Tendon Transfers

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.