Update on tendon transfers for peripheral nerve injuries

Tendon transfer surgery to restore fundamental wrist and hand function is made possible by the redundancy that exists among the actions of our upper-extremity musculature. Potential donors for transfer are those muscles with adequate power to motor the recipient tendon, similar tendon excursion to the recipient, and function in phase with the recipient. Resolution of wound healing, union of fractures, and mobilization of stiff joints are prerequisites for a functioning tendon transfer. Injuries to the radial, median, and ulnar nerves occur above (high nerve injury) and below the elbow (low nerve injury). High and low nerve injuries result in different functional deficits that require unique tendon transfers to enhance function. This report discusses the various tendon transfers necessary to overcome deficits resulting from high and low radial, median, and nerve injuries.