Tendon Transfer Surgery
How is Tendon Transfer surgery performed?
Tendon transfer surgery is a specialized procedure aimed at restoring lost hand function due to nerve injury. The surgery involves the relocation of a functioning tendon from its original attachment to a new one, thereby restoring the action that has been lost.
The process begins with the surgeon making one or more incisions in the skin to locate the tendon of the extra muscle. This tendon is then detached and sewn to the tendon of the non-functioning muscle. Sometimes, more than one tendon transfer may need to be performed at a time. After the surgery, the skin is closed with stitches.
The patient may need to wear a cast or splint after the surgery to protect the new tendon transfer until the tendon heals to its new position, which usually takes one to two months. Hand therapy may be required, and the timing of this therapy varies and will be determined in a discussion with the surgeon. It is important to follow the therapist’s instructions exactly as too little movement or too much movement can both create problems.
Tendon transfer surgery is necessary when a certain muscle function is lost because of a nerve injury. If a nerve is injured and cannot be repaired, then the nerve no longer sends signals to certain muscles, leading to paralysis and loss of muscle function. Tendon transfer surgery can be used to attempt to replace that function. Common nerve injuries that are treated with tendon transfer surgery include spinal cord, radial nerve, ulnar nerve, or median nerve injury.
Tendon transfer surgery may also be necessary when a muscle has ruptured or been lacerated and cannot be repaired. Common muscle or tendon injuries that are treated with tendon transfer surgery include tendon ruptures due to rheumatoid arthritis or fractures. Also, tendon lacerations that cannot be repaired after injury may be treated with tendon transfer surgery.
In some cases, babies are born without certain muscle functions. In these situations, the missing muscle functions can sometimes be treated with tendon transfer surgery. Common conditions treated this way include hypoplastic thumbs and birth brachial plexopathy.
What are the risks of Tendon Transfer surgery?
While tendon transfer surgery can significantly improve hand function and quality of life for patients with nerve or muscle injuries, it is not without risks. Patients should be fully informed about these risks and should work closely with their healthcare team to minimize them and ensure the best possible outcome. Tendon transfer surgery, while highly beneficial in restoring lost hand function, does come with certain risks.
The early risks, although rare, can include bleeding, infection, or injury to nearby nerves, tendons, or blood vessels. These complications can arise due to the surgical incisions made during the procedure. All surgeries produce a surgical scar and surgical incisions may develop infection.
Later risks include hand stiffness, weakness of the transferred muscle, or rupture of the transfer, which may necessitate another surgery. The transferred muscle may not regain its full strength, leading to weakness. Additionally, the hand may become stiff due to the immobilization required post-surgery.
Sometimes the tendon transfer does not heal into its new position. This could be due to various factors such as the patient’s overall health, the quality of the tendon tissue, and the post-operative care and rehabilitation. Moreover, all surgeries require the use of anesthesia, which carries its own set of risks. These risks can range from minor side effects like nausea and vomiting to more serious complications like allergic reactions or breathing problems.
Tendon Transfer Surgery Recovery
Recovery from tendon transfer surgery is a gradual process and involves several stages.
Immediately after the surgery, the patient may need to wear a cast or splint to protect the new tendon transfer until the tendon heals to its new position. This immobilization period usually lasts one to two months. During this time, it is crucial to limit movement to prevent damage to the newly transferred tendon.
Hand therapy is often a critical part of the recovery process. The need for hand therapy and the timing of therapy varies and will be determined in a discussion with the surgeon. It is important to attend hand therapy if it is prescribed and to follow the therapist’s instructions exactly. Too little movement or too much movement can both create problems.
The goals for the surgery and recovery should be discussed with the foot and ankle orthopedic surgeon before proceeding with any procedure. Some tendon transfers allow the ankle and foot to move up and down and regain some strength and motion. Others bring the foot into a position where it is easier to walk, stand, and wear shoes, but will not increase range of motion.
Realigning the foot and ankle can also decrease pain by more evenly distributing pressure across the foot. In some cases, a tendon transfer may eliminate the need for a brace altogether.
It’s important to note that full recovery can take up to 12 weeks. During this period, patients should avoid strenuous activities and follow the post-operative care instructions provided by their healthcare team.
Preparing for a Tendon Transfer Surgery
Preparing for tendon transfer surgery involves several steps to ensure a successful procedure and recovery.
Before the surgery, patients are usually given specific instructions by their healthcare team. These instructions may include not eating or drinking anything after midnight on the day before surgery. This is to prevent complications during anesthesia.
Patients may also be asked to stop taking certain medications such as aspirin or ibuprofen. These medications can increase the risk of bleeding during surgery. Therefore, it’s important to discuss all medications, including over-the-counter drugs and supplements, with the healthcare team.
If the patient has a splint or a cast, they may be instructed to remove it before the surgery. This is to allow the surgeon to have unobstructed access to the surgical site.
In terms of anesthesia, the type used depends on the injury and is a decision made between the patient and the surgeon. The surgery may be performed with the patient awake, under mild sedation, or completely asleep. If general anesthesia is used, patients should prepare to have someone drive them home after surgery, as they will not be able to drive for 24 hours.
It’s also important for patients to understand the goals of the surgery and the expected recovery process. This includes understanding the potential risks and benefits of the procedure. Patients should have a thorough discussion with their surgeon about these aspects before proceeding with the surgery.
Preparing for tendon transfer surgery involves following specific pre-operative instructions, understanding the goals and risks of the surgery, and arranging for post-operative care and support.
Tendon Transfer surgery in Iran
Equipped hospitals, and advanced specialized centers with experienced doctors and specialists are available in all medical treatment areas in Iran. Also, good hotels and entertainment centers have made Iran an appropriate choice for patients who are dealing with a tendon injury and need a Tendon Transfer.
Tendon Transfer surgery cost in Iran
The cost of tendon transfer surgery can vary widely depending on several factors, including the specific procedure being performed, the surgeon’s expertise, the healthcare facility, and the region.
In Iran, medical tourism has been on the rise in recent years, with many people traveling to the country for various medical procedures, including tendon transfer surgery. The country is known for its high-quality healthcare services and affordable prices. However, it’s important to note that the cost of tendon transfer surgery in Iran can vary depending on the specifics of the case. Factors that can influence the cost include the complexity of the surgery, the surgeon’s expertise, the type of anesthesia used, and any additional treatments or therapies that may be required.
The cost of tendon transfer surgery in Iran is around 1000-1500 USD, which is generally considered to be more affordable compared to many Western countries. Patients are advised to contact healthcare providers directly for the most accurate and up-to-date pricing information.
In addition to the cost of the surgery itself, patients should also consider the costs associated with travel, accommodation, and any necessary follow-up care. It’s also important to check whether the cost of the surgery includes post-operative care and rehabilitation, as these can add significantly to the overall cost.
