Why you may need a tendon transfer surgery?
The tendon is the strong cord at either end of a muscle that is connected to the bone. Tendons enable you to move your joints coupled with their muscles.
There are over forty various muscles in your forearm and hand. Numerous of these muscles function as overlapping functions. Following an injury, you may not be able to move some of your muscles precisely. A tendon transfer surgery moves a working muscle and tendon to substitute a not-functioning muscle and tendon.
For instance, when you a brake your wrist, the tendon to the thumb (EPL tendon) that enables you to make a “thumbs-up” can break. Oftentimes, the two edges of the tendon are very damaged and there is no way to sew them back together.
However, there are two tendons that extend the index finger which this finger can function well with just one. A hand surgeon can transfer one of your index finger tendons to the thumb to enable you to give a “thumbs-up” again.
What are the causes?
A patient may need a tendon transfer to reestablish muscles function after loss of muscle or tendon function from:
- Nerve injury which can be cut, stretched or torn nerve
- Muscle injurycaused by trauma, rheumatoid arthritis
- Neuromuscular disorder such as cerebral palsy, stroke and as well as spinal muscle atrophy
- And birth defect – when infants born without certain muscle functions
You may have the surgery with you awake, while you may have mild sedation, or also when you are completely asleep. The type of anesthesia given will depend on a patient’s injury. This is usually a decision made between the patient and his/her surgeon.
During the surgery, the surgeon does one or more incisions (cuts) in your skin. When he finds the tendon with extra muscle, he moves it and sews it to the tendon of the muscle which is not functioning. Sometimes there is a need for more than one tendon transfer to be done at once. When surgery is done, the surgeon then closes the skin with stitches.
Following the tendon surgery, patients may have a cast or splint to preserve the new tendon transfer until the tendon recovers to its new place. This normally lasts one to two months. The requirement for hand therapy and the timing when therapy is needed differs and will be defined in consultation with the patient’s surgeon. It is necessary to attend for hand therapy if it is appointed and to follow the therapist’s guidance precisely. Even too little movement or too much movement can both cause new problems.
What are the risks of tendon transfer surgery?
In general, the early risks are uncommon, however, it can lead to bleeding, infection or as well as injury to nearby nerves, tendons or blood vessels. Following risks involve hand stiffness, feeling the weakness of the transferred muscle, or break of the transfer and necessity for another new surgery.
In addition, your surgeon will also consult with you if there are any choices for your particular injury. Some other alternatives may involve the following:
- Restoration or transfer of nerves
- Restoration of muscle or tendon
- Splinting or fusion of joints
You can discuss the most suitable therapy decision for you with your hand surgeon.
What is posterior tibialis tendon surgery?
Posterior tibialis tendon surgery is a procedure to repair the tendon on the back of the patient’s calf that goes down the inside part of his or her ankle. A surgeon can provide a few various kinds of surgery to repair this tendon.
In general, the posterior tibialis tendon is one of the strong cord of tissue. In fact, this tendon is one of the most important tendons in everyone’s leg. It connects the posterior tibialis muscle on the back of individuals calf to the bones on the inside of his or her foot. It supports your foot and maintains up its arch when you are walking.
When you have an injury, it might rip this tendon or make it become inflamed. The tendon can also be torn or become inflamed from overuse. Surgery attempts to fix this damage.
During the tendon surgery, patients will probably be sedated so that they sleep. The surgeon will do a cut in the back of the patient’s lower calf. Then he will either eliminate or repair the damaged part of his or her tendon. If the damage to your tendon is a lot, the surgeon might replace a portion or whole tendon with another one taken from another area in your foot. In addition, he or she may implement other forms methods to fix your tendon as well.
What is a tendon graft?
In general, before whipstitch implantation tendon grafts should be cleaned of all non-tendinosis tissue. Nevertheless, it is needless to clean 100% of the muscle fibers from the graft.
Because the graft can be damaged with overly aggressive attempts. Still, following the whipstitches are put in, the surgeon should repeat trim off loose pieces of tissue with Adson forceps from the tendon ends.
It is necessary to debulk the tendon ends in this way. The whipstitches add bulk such that the tibial end is usually 8–10 mm, most generally 9 mm.
If the ends are not debulked, the graft can probably need an 11-mm tunnel. The application of a sizing cylinder can further support streamline the ends and narrow them by 0.5 mm or so.