Restoring hand function after spinal cord surgery

Damage to the upper spine may cause paralysis (tetraplegia or quadriplegia). In some cases, tendon transfer can restore function to the arms and legs.

Dr James McLean will advise any changes or alterations which need to be made to this program for your individual case.

What is a tendon transfer?

A tendon transfer procedure can be used to restore the function of the hand(s) following A spinal cord injury. It involves taking a working muscle and connecting a section of its working tendon to a muscle that does not work. This enables a functioning muscle to compensate for paralysed ones. The tendon that is transferred is usually autologous (taken from your own body), which reduces your chances of infection and rejection.

A tendon transfer relies on having functional muscles to connect to. Tendon transfer surgery is recommended for people who still have some muscle control.

What can be achieved with a tendon transfer

  • Restoration of straightening and bending of the elbow
  • Restoration of straightening and bending of the wrist
  • Improved grip and pinch function

Elbow tendon transfer (elbow extension)

In an elbow tendon transfer, part of the deltoid muscle is detached from the shoulder and grafted to the elbow. This imitates the function of the triceps muscle which allows you to straighten your elbow. Added elbow function can help you propel a wheelchair, reach for objects, and potentially drive.

Wrist and hand tendon transfer (for key pinch)

Wrist and hand tendon transfer involves rerouting functioning muscles / tendons from the forearm and attaching them to the tendons in your hand and fingers. This can help restore grasping and pinching motions, which can help you eat, brush your teeth, write, or use a mobile phone.

Electronic implants

These are a new alternative available for patients where tendon transfers are not viable. Similar to a pacemaker, electronic implants stimulate muscles using small electrical signals. These can initiate grip and pinching actions.

What can we expect from tendon transfer surgery?

Tendon transfer surgery normally lasts about 2 to 6 hours (depending on the tendons involved and the complexity of the procedure). As it is an invasive procedure, certain risks are involved. Dr James McLean will discuss these with you prior to your procedure.

Tendon transfer surgery generally achieve a wonderful outcome for patients, restoring their hand and arm function. The best outcomes are achieved with appropriate and timely post-operative rehabilitation / hand therapy.

Patient resources for hand conditions

Check out Dr McLean’s articles on hand related information and post surgery information.

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