tendon transfers and arm generally updates

[athos]

George I'm putting bits of the emails I sent u here on the boards for benefit of others.

The transfers are beginning to really work now (after over 6 months). In the beginning I was a bit concerned about how weak my wrist extension was, and I could hardly extend my wrist as far as neutral. But recently the muscles have started to strengthen considerably, and they seem to be working pretty well. I can now lift light objects without any problem. Wrist extension is getting much stronger now, and I can extend just a bit beyond neutral, which is how it's supposed to be. The fingers and thumb also open nicely before gripping things (one of the problems before op. was that my hand just wouldn't open up). Also I havent noticed any reduction in grip strength at all. My grip is still as strong as ever. So all in all I am very pleased, and it still getting better (I'm seeing the doc. again in January). But it did take some time. Initially the muscles just were not working very well. Perhaps they take some time to get used to their new positions. I asked the doc. how long progress takes, and he said it varies. Then I said , how about a year? And he said yes it could take that long. But he didn't give much away.

By the way, I went to see this week both the doc. who operated my wrist (Carlstedt) and my plexus (P. Richardson). They were both happy. I'm seeing Carlstedt again in Jan 2003, and Richardson in March 2003. Evidently they both expect more progress.

just wanted to add 1 more thing about my arm generally, that it seems still to be getting stronger as I swim slightly faster and faster, and I get done quite a few lengths. The doctors just don't really seem to know when improvement is going to stop, which I think is a good sign indicating that they are good docs. Carlstedt said I might get improvement even as far as 5 yrs down the line, but both Carlstedt and Richardson agree that I already had most of the improvement. It doesn't surprise me as the limb used to be completely flail. A good thing is that I never lost grip strength.

I injured myself in Jan. 2000. That's about it. Ciao.

Athos

[George]

Patience is a virtue, huh ? Great news Athos !! It has been about 9 months since your surgery ?? Good to hear the docs are expecting more. Must have been a challenge re-training your mind to use the transfers. I've e-mailed you......thanks for posting an update !!

George

[admin]

Cool good news.............. Kathy

[Aspacia]

I had 9 tendon tranfers but with mine it caused my hand to close as for flextion instead of open. Is there a way to open the hand and still aquire strength

[Paul]

Athos how are you doing now? I had a tendon trensfer on my wrist it camr out very good. How is yours doing now? ? Paul

[admin]

Hi,

yeah, it's doing very well. Definitely the op. was a success. Wrist extension is reasonably strong. A massive improvement compared to before. Very happy with it.

Ciao, Athos

[Helen C]

Hi

I am trying to find some people who have had tendon transfer folowing BPI to help me work out whether I should go for it or not (I realise we are all different) and also what to ask my medics.

I broke my left collar bone and humerus in aRTA nearly 2 years ago. Was diagnosed as having radial nerve palsy but this year they decided it was BPI.

My last EMG was January- no progress since the previous Oct and severe wastage of muscle (depsite physiotherapy) in my forearm.

My arm movement is pretty good although I have diminished strength. I have no indepedent movement in my wrist (and only limited assisted movement). Can grip large things but cannot, eg, type or play musical instruments and my fingers are generally quite stiff despite exercise. My surgeon says that there is only a70% chance of success - and is a bit hazy about what success might mean. Can you help?

Hope your recovery is going well

Helen

[athos]

Hi,

I don't think I can really help. As u said, we are all different, and I don't know exactly what u have damaged and what ur movement is. Eg. me and Karl thought we were going to have the same op., and it turned out that he has 2 long parallel incisions on the outer and inner part of his forearm, whilst I have 1 long incision on the inner part of my forearm and 3 smaller incisions scattered on the outer part of forearm. So obviously not even we had the same op., although we had the same problem, ie. lack of fingers/thumb/wrist extension due to radial nerve palsy.

Though, 1 thing I can tell u is that pre-op. it is very important for donor muscles to be as strong as possible, ideally normal strength, as in my case.

Another issue is grip strength pre-op. In my case it was normal, although I couldnt open my hand and my wrist dropped (lack of wrist/finger/thumb extension). I know that Karl had substantially reduced grip strength after his op., but prolly got better later on with PT, although I don't know. Perhaps Karl u can give us a final update on ur tendon transfer op.

But the bottom line is that we are all different. What u probably can do is to get a 2nd opinion from other orthopaedic surgeon. Time is on ur side, and it's worth getting the best results.

[admin]

Hi Athos

Thanks for both your replies. I had thought about getting a second opinion - but have the (usual?) hang ups about not wanting to brass my doc off- but then I remind myself whose arm it is!

Thanks again

Helen

[karlos]

Hi Athos...everyone
As Athos said we both had the same situation going on.....My grip strength pre op was around 60%, post op this went down to 35% and i was quite concerned. I neednt have been as 1 year later the grip got back to 60/70 % of pre accident grip
The op takes around 2 or 3mth before the results are to be seen properly but in my case it was over a year with plenty of phisio before the strength was back to normal, this op worked well for me and Athos but as he said you do need a fair degree of grip in the first instance, becouse after all their just " robbing peter to pay paul" especially if there using the mouscle to cure the wrist drop aswell

karl