A tendon transfer is a surgical procedure used to restore hand function in the aftermath of a nerve injury. Nerve damage that leads to loss of hand function can occur in your spine or in several nerves in your arm and hand. Rehabilitation from a tendon transfer is an extensive process that can take a year or more to complete.
Tendon Transfer Basics
Normally, your tendons connect your muscles to your bones and allow you to use your muscles and move your body. During a tendon transfer procedure, your surgeon will remove part of a tendon from one of the more than 40 muscles in your lower arm and hand. He will then take this partial tendon and sew it into another tendon or attach it to another bone. In this way, he will try to bypass the point of nerve damage and give your body an alternate way to control your hand. Since a tendon transfer occurs in the aftermath of nerve damage, it is itself a form of rehabilitation.
Basic Rehabilitation
After you undergo a tendon transfer, you will need to wear a cast for roughly three weeks to two months. Rehabilitation will begin once your cast is removed. In the early phases of rehabilitation, your doctor and/or physical therapist will guide you through exercises designed to gently restore your hand's range of motion while simultaneously protecting you from injury. During this time, your rehabilitation team may also use biofeedback to help you relearn how to use your hand muscles. In addition, your doctor and therapist will typically show you how to continue to exercise at home and instruct you to schedule follow-up visits so they can track your progress.
Advanced Rehabilitation
If you make sufficient progress in the early stages of your recovery program, your physical therapist will start asking you to perform exercises that mimic everyday hand motions and prepare you for independent hand use. He will also add exercises designed to strengthen your hand muscles and add exercises specifically targeted to restore normal function in your thumb. When you reach this stage of rehabilitation, your success in relearning how to use your hand typically depends heavily on participation in a supervised program, according to the American Society for Surgery of the Hand.
Rehab Considerations
Some people who undergo tendon transfer must undergo two operations to complete the repair process, the Spinal Cord Injury Association of Illinois explains. If you require two procedures, you will frequently complete the early stages of rehabilitation, undergo your second surgery, then complete your recovery. Some people need two surgeries to complete repair of one hand, while others need separate surgeries for each hand. If you're scheduled for tendon transfer surgery, ask your surgeon how may procedures you will need. In addition, ask your surgeon and physical therapist to explain the likely course of your rehabilitation.
