Loss of Hand After Rotator Cuff Surgery

[Greeny]

Since the doctors have stated that the muscles of the hand will atrophy and shrink before the regenerated nerves reach the hand, I have a question. Has anyone heard of a muscle transplant of the hand being performed?
I would think that once the regenerated nerves reach my dead muscle and a transplanted muscle is put in place, the nerves would have something viable to attach to. Just thinking outside of the box.

[Greeny]

BUMP Still hoping someone might know anything about muscle transplant to the hand.

[Christopher]

I hate to say it, but you'd probably have a better chance getting a hand transplant.

Where from the body would you harvest those small and precise muscles from the give the hand such articulate and exact movement and control from? Where would you get all the different nerves necessary to power to activate such delicate and precise movements to so many different individual muscles that are in the hand?

The current muscle transfer that happens now, gracilis to biceps, is still rather young here in the states, and done by a handful of surgeons and it still has its difficulties. My arm used to be able to curl 80 pounds, I had the gracilis transfer to biceps area and biceps re-innervation as well via intercostal nerves (nerve from ribs), and with both of those, I can only curl about 5 pounds. When a muscle gets re-innervated, that nerve has to come from somewhere and there will be a sacrifice of loss from where it comes and what function that nerve used to have, same with the muscles. Then there has to be the whole retraining of the brain in order to get that newly targeted muscle to fire and flex while the brain is still programed to fire the original muscle(s) that the transfered nerve was connected to. For me to get any deltoid contraction on my injured right arm, I have to flex my left arms triceps and make a fist (half C7 transfer from left side to right deltoid). This is after 5 years. My brain wouldn't retrain itself for this action to become second nature.

I hope this helps a little bit. You never know though, keep thinking out of the box! If you can think of answers to some of the questions, post them. I'm all about coming up with your own solutions, instead of waiting for someone else to save my butt. My sister and I invented a world first surgery that the doctors at the Mayo Clinic preformed to give me back some triceps function. And that all started with the same kind of question you asked and then months of research and then surgery.

Chris

[Greeny]

Thank you for the reply. You are absoloutely right about the intricate muscles of the hand but one can only hope.

[admin]

in reply to your question if you have muscles now could you not make them function by electrical stimulation therefore keeping the muscles alive until the nerves grow back any thoughts out there on this
good luck regards jamie

[rbwalton]

Hi Greeny

My problem is not nearly as involved as yours. But, you asked originally for time lines. Due to what at the time was thought to be Anterior Interosseous Nerve Syndrome, I had lost the use of my right thumb, index finger and part of second finger of my dominant right hand. At the time I was 46. The doctors told me I was too old for the nerves to grow back, and recommended tendon transfers. I said no, and waited to see what would happen. For two years or so, I did muscle stimulation every other day or so from my forearm down into the hand and fingers. Every non impacted finger worked just fine, but the stimulation unit could not raise or flex my thumb or index finger.

Daily, and literally for hours each day, I tried to flex my hand and non responding fingers. At times I moved them with my left hand to force the tendons to stay limber. I concentrated every effort on moving those fingers and thumb. I started to dream about the hand coming back. It felt so real in the dream, but when I woke up, the fingers were still dead. I kept at it daily for two years, and a full year after the doctors had given up on seeing me any more, I had a sudden electric sensation in my index finger, similar to the muscle stimulation unit, but I was not using it at the time. The nerves to my index finger reconnected after two years. After another couple of years, I started to see ever so slight flexion movement in my thumb. I continued to work on it daily. Then by 2005, I had fairly good movement in my thumb, but very little strength. So 5 years out from the injury, my progress on the thumb seemed to have stopped. Two years out I had pretty much 100% return on my index finger. Five years out, I had only partial return on my thumb.

In 2006, I had an attack of what was determined to be BPN, taking out my right scapula. At that point I realized that my hand problem was also caused by this.
Good luck
Richard

[Alecia]

As far as using ESTIM to keep those muscles viable -

We have been using ESTIM daily for nearly 2 years. Great Bicep return (Double Oberlin procedure)but still no Deltoid (18 months post op). The deltoid continues to atrophy and now looking at surgery Aug 28th for muscle and tendon transfers. Before Glynn's bicep starting firing, it didn't respond to ESTIM at all. Once the nerve starting firing, he continued to use the ESTIM for strengthening. I wish you could use estim in the affected muscle to keep the viable tissue/size/strength, but it didn't seem to work that way for us.

[Greeny]

Nerves have already regenerated down to the hand. Problem now is that the hand has atrophied and hand muscles have shrunk up to nothing, thereby giving nothing for the nerves to attach to. Consequently, dead hand. Oh,also the knuckles have locked at the hand, making flexing of the hand impossible. Little finger has begun to claw on me already and thumb has no action what-so-ever.


Message was edited by: Greeny

[swhite1]

Hi Greeny. First of all, thank you for your service to country. I must say each time I log on to UBPN I learn something new. Until reading these particular posts I had every intention of regaining most all use of my arm and hand back. As a disabled vet I am able to visit with lots of us at the Dallas Veterans Administration Hospital. In '06 I met up with two vets who had suffered a BPI by totally different means as myself and each other. They both had lost significant use of arms and hands. The inspiration here is that they both had 80-90% return after a few years. And both without surgery.
For what it's worth...
Chin up, head down,
Scott

[Tgreuling]

How did all of you make out with blue hands after rotators surgery ? I am going thru it now . Need to have a MRI and EMG next week.i wish there we're follow up stories. Thanks