eMedicine Specialties > Plastic Surgery > Hand

Tendon Transfer Principles and Mechanics: Multimedia

Author: Premal Sanghavi, MD, Consulting Staff, Department of Surgery, St Mary's Hospital, Leonardtown, Maryland and Philip J Bean Medical Center, Hollywood, Maryland
Coauthor(s): Mohammad Azhar Ali, MD, MBBS, Consulting Plastic Surgeon, PC
Contributor Information and Disclosures

Updated: Oct 3, 2008

Multimedia

Tendon transfer principles and mechanics. Incisi...Media file 1: Tendon transfer principles and mechanics. Incisions used in the standard (flexor carpi ulnaris) combination of transfers.
Tendon transfer principles and mechanics. Incisi...

Tendon transfer principles and mechanics. Incisions used in the standard (flexor carpi ulnaris) combination of transfers.

Tendon transfer principles and mechanics. Pronat...Media file 2: Tendon transfer principles and mechanics. Pronator teres (PT) to extensor carpi radialis brevis (ECRB) transfer. Also pictured are the extensor carpi radialis longus (ECRL) and brachioradialis (BR).
Tendon transfer principles and mechanics. Pronat...

Tendon transfer principles and mechanics. Pronator teres (PT) to extensor carpi radialis brevis (ECRB) transfer. Also pictured are the extensor carpi radialis longus (ECRL) and brachioradialis (BR).

Tendon transfer principles and mechanics. Palmar...Media file 3: Tendon transfer principles and mechanics. Palmaris longus (PL) to rerouted extensor pollicis longus (EPL) transfer.
Tendon transfer principles and mechanics. Palmar...

Tendon transfer principles and mechanics. Palmaris longus (PL) to rerouted extensor pollicis longus (EPL) transfer.

Tendon transfer principles and mechanics. Flexor...Media file 4: Tendon transfer principles and mechanics. Flexor carpi radialis (FCR) to extensor digitorum communis (EDC) transfer. Also pictured are the extensor pollicis longus (EPL), extensor carpi radialis brevis (ECRB), and pronator teres (PT).
Tendon transfer principles and mechanics. Flexor...

Tendon transfer principles and mechanics. Flexor carpi radialis (FCR) to extensor digitorum communis (EDC) transfer. Also pictured are the extensor pollicis longus (EPL), extensor carpi radialis brevis (ECRB), and pronator teres (PT).

Tendon transfer principles and mechanics. Flexor...Media file 5: Tendon transfer principles and mechanics. Flexor digitorum superficialis (FDS) transfer used as an "internal splint" for low ulnar nerve palsy. Also pictured are the flexor digitorum profundi (FDP), the adductor pollicis, and the abductor pollicis brevis (APB).
Tendon transfer principles and mechanics. Flexor...

Tendon transfer principles and mechanics. Flexor digitorum superficialis (FDS) transfer used as an "internal splint" for low ulnar nerve palsy. Also pictured are the flexor digitorum profundi (FDP), the adductor pollicis, and the abductor pollicis brevis (APB).

Tendon transfer principles and mechanics. Capsul...Media file 6: Tendon transfer principles and mechanics. Capsulodesis of the metacarpophalangeal (MP) joint to control claw deformity.
Tendon transfer principles and mechanics. Capsul...

Tendon transfer principles and mechanics. Capsulodesis of the metacarpophalangeal (MP) joint to control claw deformity.

Tendon transfer principles and mechanics. Dorsal...Media file 7: Tendon transfer principles and mechanics. Dorsal tenodesis to control claw deformity.
Tendon transfer principles and mechanics. Dorsal...

Tendon transfer principles and mechanics. Dorsal tenodesis to control claw deformity.

Tendon transfer principles and mechanics. Transf...Media file 8: Tendon transfer principles and mechanics. Transfer of a flexor digitorum superficialis (FDS) to control claw deformity.
Tendon transfer principles and mechanics. Transf...

Tendon transfer principles and mechanics. Transfer of a flexor digitorum superficialis (FDS) to control claw deformity.

Tendon transfer principles and mechanics. Transf...Media file 9: Tendon transfer principles and mechanics. Transfer of the extensor carpi radialis longus (ECRL) to control claw deformity.
Tendon transfer principles and mechanics. Transf...

Tendon transfer principles and mechanics. Transfer of the extensor carpi radialis longus (ECRL) to control claw deformity.

Tendon transfer principles and mechanics. Transf...Media file 10: Tendon transfer principles and mechanics. Transfer of flexor digitorum superficialis (FDS), through a facial pulley, to the abductor tubercle of the thumb.
Tendon transfer principles and mechanics. Transf...

Tendon transfer principles and mechanics. Transfer of flexor digitorum superficialis (FDS), through a facial pulley, to the abductor tubercle of the thumb.

Tendon transfer principles and mechanics. Tip pin...Media file 11: Tendon transfer principles and mechanics. Tip pinch. A slip of the abductor pollicis longus (APL) is elongated with a free tendon graft from the palmaris longus (PL) or plantaris and inserted into the tendon of the first dorsal interosseous.
Tendon transfer principles and mechanics. Tip pin...

Tendon transfer principles and mechanics. Tip pinch. A slip of the abductor pollicis longus (APL) is elongated with a free tendon graft from the palmaris longus (PL) or plantaris and inserted into the tendon of the first dorsal interosseous.

Tendon transfer principles and mechanics. Transf...Media file 12: Tendon transfer principles and mechanics. Transfer of the ulnar half of the extensor digiti minimi (EDM) to correct persistent abduction of the little finger.
Tendon transfer principles and mechanics. Transf...

Tendon transfer principles and mechanics. Transfer of the ulnar half of the extensor digiti minimi (EDM) to correct persistent abduction of the little finger.

Tendon transfer principles and mechanics. Finger ...Media file 13: Tendon transfer principles and mechanics. Finger and wrist flexion. Side-to-side tenodesis of the profundus tendons of the ring and the little fingers to the profundus of the long finger in the forearm increases the power for gross grip.
Tendon transfer principles and mechanics. Finger ...

Tendon transfer principles and mechanics. Finger and wrist flexion. Side-to-side tenodesis of the profundus tendons of the ring and the little fingers to the profundus of the long finger in the forearm increases the power for gross grip.

Tendon transfer principles and mechanics. Techniq...Media file 14: Tendon transfer principles and mechanics. Techniques of distal attachment as described by Brand, Littler, Riordan, and Royle and Thompson.
Tendon transfer principles and mechanics. Techniq...

Tendon transfer principles and mechanics. Techniques of distal attachment as described by Brand, Littler, Riordan, and Royle and Thompson.

Tendon transfer principles and mechanics. Extens...Media file 15: Tendon transfer principles and mechanics. Extensor indicis proprius (EIP) opponensplasty.
Tendon transfer principles and mechanics. Extens...

Tendon transfer principles and mechanics. Extensor indicis proprius (EIP) opponensplasty.

Tendon transfer principles and mechanics. Extrins...Media file 16: Tendon transfer principles and mechanics. Extrinsic replacement using the brachioradialis to the flexor pollicis longus (A) and the extensor carpi radialis longus to the profundi of the index and long fingers (B). In both situations, the transfers as shown are end-to-end. If the patient has any chance of extrinsic return following grafting, the transfer should be end-to-side. The end-to-end technique shown here is used in patients with no chance of extrinsic return.
Tendon transfer principles and mechanics. Extrins...

Tendon transfer principles and mechanics. Extrinsic replacement using the brachioradialis to the flexor pollicis longus (A) and the extensor carpi radialis longus to the profundi of the index and long fingers (B). In both situations, the transfers as shown are end-to-end. If the patient has any chance of extrinsic return following grafting, the transfer should be end-to-side. The end-to-end technique shown here is used in patients with no chance of extrinsic return.

More on Tendon Transfer Principles and Mechanics

References

References

  1. Bell LD. Repair of peripheral nerves. In: Reconstructive Plastic Surgery. Vol 6. 3215-42.

  2. Bell LD. Transplantation of tendon. In: Reconstructive and Plastic Surgery. Vol 1. 266-92.

  3. Cohen M. Tendon transfers. In: Mastery of Plastic and Reconstructive Surgery. Vol 1. Boston: Little Brown and Company; 1994:1579-97.

  4. Green DP, Hotchkiss R, Pederson WC. Nerve reconstruction. In: Green's Operative Hand Surgery. Vol 2. Churchill Livingstone; Ch 37-9; pp 1479-554.

  5. McCarthy JG, May JW, Littler JW. The hand, part 2. In: Plastic Surgery. Vol 8. Ch 114; pp 4923-65.

Further Reading

Keywords

standard flexor carpi ulnaris transfer, FCU transfer, superficialis transfer, flexor digitorum superficialis transfer, FDS transfer, flexor carpi radialis transfer, FCR transfer, ulnar nerve palsy, low ulnar nerve palsy, flattened metacarpal arch, tenodesis, claw deformity, capsulodesis of the metacarpophalangeal joint, dorsal tenodesis, metacarpal arch restoration, median nerve palsy, Royle-Thompson opponensplasty, Bunnell opponensplasty, proprius extensor tendon opponensplasty, extrinsic replacement, muscle-tendon unit, muscle transfer, tendon transfer, muscle transplant, tendon transplant, muscle repair, tendon repair, muscle, tendon

Contributor Information and Disclosures

Author

Premal Sanghavi, MD, Consulting Staff, Department of Surgery, St Mary's Hospital, Leonardtown, Maryland and Philip J Bean Medical Center, Hollywood, Maryland
Premal Sanghavi, MD is a member of the following medical societies: American College of Surgeons and Association of Women Surgeons
Disclosure: Nothing to disclose.

Coauthor(s)

Mohammad Azhar Ali, MD, MBBS, Consulting Plastic Surgeon, PC
Mohammad Azhar Ali, MD is a member of the following medical societies: American College of Surgeons, American Medical Association, American Society of Plastic Surgeons, and Michigan State Medical Society
Disclosure: Nothing to disclose.

Medical Editor

Milton B Armstrong, MD, FACS, Associate Professor of Clinical Surgery, Associate Professor of Clinical Orthopedics, Department of Surgery, University of Miami Miller School of Medicine
Milton B Armstrong, MD, FACS is a member of the following medical societies: American Association for Hand Surgery, American Association of Plastic Surgeons, American Cleft Palate/Craniofacial Association, American College of Surgeons, American Medical Association, American Society for Reconstructive Microsurgery, American Society for Surgery of the Hand, and National Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

David W Chang, MD, FACS, Associate Professor, Department of Plastic Surgery, MD Anderson Cancer Center, The University of Texas
Disclosure: Nothing to disclose.

CME Editor

Nicolas (Nick) G Slenkovich, MD, Practice Director, Colorado Plastic Surgery Center at Swedish Medical Center
Nicolas (Nick) G Slenkovich, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Medical Association, American Society of Plastic Surgeons, and Colorado Medical Society
Disclosure: Nothing to disclose.

Chief Editor

Subhas Gupta, MD, PhD, CM, FRCS(C), FACS, Professor of Surgery, Chair, Department of Plastic Surgery, Director of Plastic Surgery Residency, Director of Comprehensive Wound Service, Department of Plastic Surgery, Loma Linda University School of Medicine
Subhas Gupta, MD, PhD, CM, FRCS(C), FACS is a member of the following medical societies: American Association of Plastic Surgeons, American Burn Association, American College of Phlebology, American College of Surgeons, American Medical Association, American Medical Informatics Association, American Society of Plastic Surgeons, California Society of Plastic Surgeons, Canadian Medical Association, Canadian Society of Plastic Surgeons, Canadian Society of Plastic Surgeons, College of Physicians and Surgeons of Ontario, Plastic Surgery Research Council, Quebec Medical Association, Royal College of Physicians and Surgeons of Canada, and Wound Healing Society
Disclosure: Nothing to disclose.

 
 
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