Update on tendon transfers for peripheral nerve injuries.

Area of Science:

• Orthopedic Surgery
• Neuroscience
• Reconstructive Surgery

Background:

• Upper extremity musculature offers redundancy for tendon transfer surgery.
• Successful tendon transfers require donor muscles with adequate power and similar excursion.
• Pre-operative conditions like wound healing and joint mobility are crucial for functional outcomes.

Purpose of the Study:

• To discuss tendon transfers for restoring wrist and hand function.
• To outline strategies for managing functional deficits from high and low nerve injuries.

Main Methods:

• Review of anatomical redundancy and muscle selection criteria for tendon transfers.
• Analysis of functional deficits associated with radial, median, and ulnar nerve injuries (high vs. low).
• Discussion of specific tendon transfer techniques tailored to nerve injury levels.

Main Results:

• Identified criteria for selecting donor tendons based on power, excursion, and functional phasing.
• Differentiated functional deficits resulting from nerve injuries above and below the elbow.
• Presented a framework for choosing appropriate tendon transfers based on injury type.

Conclusions:

• Tendon transfer surgery is a viable option for restoring function after nerve injuries.
• Tailored tendon transfers are essential to address specific deficits from high and low nerve injuries.
• Understanding muscle redundancy and injury patterns guides effective surgical reconstruction.