A little over 2 years post injury, prognosis is this is probably as good as its gonna get in terms of bpi recovery.
The work comp eval reccomended a hand specialist consult for tendon transfer to improve hand function. We had the consult but were not very optimistic going into it since the injury wasn't to his hand directly.
The hand/arm/shoulder specialist explanation was that that he cannot do anything for the bpi directly but because he does have some movment control in his hand that he is a canidate for the tendon transfer surgery(s).
They will not be transferring any muscles or tendons simply transferring the the connection points of the exsisting tendons.
The expectation is that over a course of 2-3 surgeries with approx 4-6 months of intensive theapy in between they can "re-route" the tendons that are currently working to do different things which would allow him some ability to grip things. One would focus on rerouting the tendons in each finger seperately to allow fingers to bend from the hand not simply curl at the knuckles. This may actually require 2 surgeries. The next surgery would be to reroute tendon connecting his thumb around the back of his hand and allow him to move his thumb across his hand.
These surgeries would not affect the injured nerves and would have no impact on pain or sensation but simply have the tendons that do work to work differently.
Has anyone had any experience or information about surgeries similar to this?
reconstructive tendon transfer in hand reccomended - any experience
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Christopher
- Posts: 845
- Joined: Wed Jun 18, 2003 10:09 pm
- Injury Description, Date, extent, surgical intervention etc: Date of Injury: 12/15/02
Level of Injury:
-dominant side C5, C6, & C7 avulsed. C8 & T1 stretched & crushed
BPI Related Surgeries:
-2 Intercostal nerves grafted to Biceps muscle,
-Free-Gracilis muscle transfer to Biceps Region innervated with 2 Intercostal nerves grafts.
-2 Sural nerves harvested from both Calves for nerve grafting.
-Partial Ulnar nerve grafted to Long Triceps.
-Uninjured C7 Hemi-Contralateral cross-over to Deltoid muscle.
-Wrist flexor tendon transfer to middle, ring, & pinky finger extensors.
Surgical medical facility:
Brachial Plexus Clinic at The Mayo Clinic, Rochester MN
(all surgeries successful)
"Do what you can, with what you have, where you are."
~Theodore Roosevelt - Location: Los Angeles, California USA
Re: reconstructive tendon transfer in hand reccomended - any experience
I had a very successful tendon transfer from one of my wrist flexors to my middle, ring, and pinky finger extenders. I couldn't open up those three fingers beyond a 90 degree point from my palm, which rendered my hand pretty useless. So one of the tendons that curls the wrist/hand towards the forearm was used to tie into all three finger extenders, and now it has become second nature. I had made a promise with myself, if I could use my hand to shake someone else's, then I was having my arm amputated. This surgery enables my to actually use my hand, with out it, I could maybe use my index finger and thumb to very very lightly hold something.
I think long term, when I'm thinking of surgeries. Like 20 and 40 years down the road.
Best of Luck,
Christopher
I think long term, when I'm thinking of surgeries. Like 20 and 40 years down the road.
Best of Luck,
Christopher