c6 going soon for tendon transfer plz give kind advice

[asif]

Hi all
Two weeks ago I went to plastic surgeon to discuss with him the possibilty of my tendon transfer.I am now 8years post injury and my level is c6 ASIA A .currently I am having no grip ,have wrist extension, have elbow flexion but no extension,have stong biceps but no triceps.Dr asked me that what do i want to achieve .I told that i want elbow extension or triceps to be able to transfer at my own and finger grip to some extent to be able todo small daily tasks at my own.The Dr has experience of transfring muscle of persons which are not sci .He hasnt treated sci person like me.the Dr told me to go to pysiotherapist and do muscle charting and then do nerve conducting testof arm .I will post the NCT later.my muscle charting of upper limb is as below showing ing strength of each muscle.

shoulder girdle (all muscle 4)

shoulder joint (deltoid clavicular 4,deltoid scapular 3+,deltoid acromial 3+,latissimus dorsi 3+,teres maj ,min 4,supraspinatus 4+,infrasfinafus 4-,subscappularis 4-pectorelis maj 2- )

elbow joint (biceps brachii 4-,brachialis 3+bracio radialis 3+,tricep brachi 0)

forearm (biceps brachii 3+, supinator 3+pronator teres 0,pronator quad0)
wrist (flexor carpi ulnaris 0,flexor carpi radialis 0,ext carpi ulnaris 3-,ext carpi radialis longus 3,ext carpi radialis brevis 3)

hand (all muscle 0)

thumb ( all muscle 0)


After watching the tests and discussing my case with his team Dr told me that my treatment will be in several phases.First Deltoid will be trasfer to take action of tricep. I t will extend elbow but may not to 180 degree..I will not be able to use th transferd muscle for 3 months then will do occupational therapy to start it working.Then aother surgery will be done to get some sort of grip. and then the process will be repeated on the other hand .The first operation will be done in Aug.
For th last 7 years the care cure community has helped me alot and have given me alot of information and knowledge to solve various problems which are because ofsci .Now my decision whether to go for the tendon transsfr or not will depend alot on the advices of care cure community drs,nurses and members.I hope you all will share your knowledge and experiences regarding the process and will guide me in th right direction.
Thanks alot.
Regards
Asif.
email; omego23@ gmil.com
ph; 0092-313-9334224

[maddog]

I had this done 2 years ago at the shepherd center in atlanta and it worked well. I thought they were going to use the deltoid for the tricep, but they used the bicep instead. They said over the long run the bicep worked better. The bicep brachii extends the elbow, the brachioradialis works the thumb and the brachialis is left to do all the elbow flexion. They did both surgeries at one time but recommended doing one arm at a time, I only had one arm done. I had a full cast for 3 weeks and then started rehab. The thumb was ready to go after 3 weeks but the tricep part took another 3 months to slowly stretch the bicep (15 degrees per week). I now have full range of motion in the elbow with the ability to easily lift 10lbs over my head.
I have a trace tricep in my other arm so I don't need the other are done, and one thumb is also enough. Overall I am happy with the results. Tendon transfers can be tricky, I would try to find a doctor who has done it on sci patients before.

[asif]

thanks Maddog for your comments..plz tell me that after surgery how elbow extensio have changed your life and what extra work can you do.can you only move your finger? how much your wrist function changed?
thanks

[fahad283]

Hi Asif
do u live in lahore and did u go to brigadier jaffer? Iam too interested in having tendon transfers....I had asked sci nurse a question and she said dont have tendon transfers from a surgeon who is inexperienced on sci patients.

[asif]

Hi Asif
do u live in lahore and did u go to brigadier jaffer? Iam too interested in having tendon transfers....I had asked sci nurse a question and she said dont have tendon transfers from a surgeon who is inexperienced on sci patients.

Hi Fahad ,how are you? Nice to see you on care cure form. I racently have been to CMH pindi and AFIRM. There I talked with Dr Shahid and his team.they will operate me on 11th Aug.In first phase thy will restore my elbow extension but now I am thinking to talk to them to do restore finger movement as well.At AFIRM there is facility of occupational therapy as well.
Yaar tell me yourstory. Where do you live? What is your level of injury?you can call me at 0313-9334224 so that we can talk in detail.or email at omego23@gmail.com.

[asif]

Waiting for response of cc nurses,drs and members on tendon transfer

Sci Nurse ,plz look at my muscle charting in above post and suggest me

that which muscle should I transfer for elbow extension?

Should I ask the Dr to operate for elbow extension and some sort of hand grip in one go?

Which muscle should be transfer for hand grip?

please also tell me that what additional daily task I would be able to perform after my elbow extension resoration?


Thanks a lot.

[cheesecake]

Look for posts by Chris Chappel

Hi Asif: Many years ago, Chris Chappel as well as Walderness documented their tendon transfer surgery.
I have seen the results of both of heir surgeries and it was impressive. Both Walderness and Chis went for improved hand function. I do not believe either had elbow issues.

Do a search for tendon transfer. Here is Chris's thread: /forum/showthread.php?t=5767

and here is the thread by Walderness: /forum/showthread.php?t=99433

[maddog]

thanks Maddog for your comments..plz tell me that after surgery how elbow extensio have changed your life and what extra work can you do.can you only move your finger? how much your wrist function changed?
thanks

I only had my left arm done, my weak arm. The elbow extension biggest help was with my driving of my car, lets my press the brake much harder. It also helps in a lot of little ways like transferring, brushing hair anything that takes a tricep. It is not as strong as a true tricep and if I really push hard on something I flex all biceps at once which means the two are just working against each other. Over time my brain gets better at differentiating the two and it truely does feel like a tricep, no thought involved.

Since 2/3 of my biceps are performing different tasks my elbow flexion has gotten weaker, especially when the arm is straight.

The bicep brachioradialis was connected to my thumb and this does not interfere with wrist function. This is the only finger that moves and it pinches against my index finger. It also works well, they said I would have 8 lbs of pinching force but have not had it tested.

I would try to find a sci doc to do the surgery.

[fahad283]

hi maddog,
can u please tell me how much did the tendon transfer surgery cost u?or how much did your insurance pay 4 u?

[SCI-Nurse]

I don't make recommendations for tendon transfers- the surgeons does that after they test you.
CWO