How the procedure works

Tendons are the strong collagen cords that connect muscle to bone. When a tendon crosses a joint, it transmit muscle action into joint motion. A tendon transfer repositions the tendons of a working muscle so that they take over the functions of a paralyzed muscle. This enables the working muscle to do what the paralyzed muscle used to do but can no longer do. 

For example, in the normal upper arm, the triceps muscle straightens (extends) the elbow. The deltoid muscle pulls the arm backwards, outwards and forwards away from the body. If the triceps muscle is paralyzed but the deltoid is still functional, the hand surgeon can split the deltoid muscle and via a graft connect a portion of the deltoid to reach the triceps (Figure above). This restores elbow extension without greatly diminishing shoulder function and stability.

Below is a list of functions that usually can be restored or improved in individuals with tetraplegia after spincal cord injury at the neck level.  Remember that the lower injury level the better conditions to reconstruct muscle functions.
  • ability to extend and bend (flex) the elbow
  • ability to extend and flex the wrist
  • ability to grip with the thumb and fingers
  • ability to open the hand
  • ability to rotate the forearm
  • ability to regain finger and thumb fine control in selected cases