retrainign after surgery

[admin]

can anyone tell me about the process of retraining after tendon transfer to regain wrist movement and finger extension?

what's the process?

how long does it take?

and if, like me, you're someone who can't think back to front/upside down (never been able to do hanstands eg) how easy is it?

[EllenB]

For my son, the intercostal nerves fire the transferred gracilis muscle/tendon to his hand. For him, the exercises involve types of breathing & simultaneous movement of hand/fingers to help retrain the brain. The surgery involving hand function was in mid-April, and he was first able to make a fist in September.

Hope this helps.

Ellen

[karlos]

Its just like riding a bike........Hard at first then you do it without thinking.
it takes aound 3 mth to get the tendons working properly and around 6mth to do it with out thinking about it, its weird when your not trying youll just do it , but try and show someone and you cant.
im now 2 yrs for wrist and finger extention and the transfers work great

karl

[admin]

Karl

thanks for your reply.

How much could you use your hand before surgery? and how long was it between your TBPI and your tendon transfer?

and how much can you use your hand now? what sorts of things couldn;t you do before that you can now?

sorry to bombard you with questions but I'm finding it hard to get my head round how things might be different- having lived with this for a couple of years now and learned to adapt. I met a man last night who had had a transfer but his hand doesn't seem much better than mine without. but then his was worse to start with.


thanks

helen

[EllenB]

John's accident was in Nov '02 & the surgery for hand movement in April '03. All 5 nerves were avulsed so he was completely paralyzed. He can make a fist (& like Karl wrote, he's at the point where it's a full fist with the breathing technique, and without the breathing it's around a 2/3 fist.) The real work ahead, though, will be in building strength. Lots of therapy ahead...

Between the two muscle transfers he's had, the idea is that he can eventually grip something & bring it to his face. Right now bending his arm is like the fist - the movement is very evident but building strength to go against gravity is the next thing to work on.

Ellen

[karlos]

I had fairly good grip before the transfers, prob around 70% of normal, they told me that i would lose around 30% of this grip strength after the transfers (for finger/wrist extension)
After the op i had very little grip strength but within a year i had got it back to almost as strong as before the op.
before the transfers i had to wear a wrist splint and was unable to open my hand (no extensors),afterwards i can lift my wrist like my good hand and extend my fingers almost as well as my good hand.
for this op to work well you need quite strong doner muscles ,and this sounds to be the case with you
Phisio is hard and takes some doing after but the results are quite astounding and worth all the pain.

the tendon transfers took place 5yrs after the accident when it became obvious i wouldnt regain any more function

karl

[Susana]

Karlos, when you say strong donor muscles, do you mean that if somebody works out those muscles are better for a transfer? I don't too much about it.

[karlos]

Yeh sure, if you were to strenghen the muscles as much as poss then this can only help.
Iv read elsewere were the docs have waited a few month so as you can concentrate on the doner muscles to get them as strong as you can

[Susana]

Karlos, do you know what muscles they usually transfer?