Tendon transfer rehabilitation pdf

Phase 1 protect transfer, motor retraining 06 weeks. Fashion a daytime extension splint with the following characteristics. There is an increasing tendency to use tendon transfers in the total reha. The site navigation utilizes arrow, enter, escape, and space bar key commands. Novak, pt, phd, rehabilitation of the upper extremity following nerve and tendon reconstruction. Dorxiflexionplantar flexion exercises ii intermediate phase. Rehabilitation institute of chicago 28 bed inpatient sci program since 1998, all patients referred to tendon transfer clinic by physiatrist dr. Muscle imbalance and weakness can become so severe that the involved extremity can be rendered nonfunctional. Radial nerve transfer fcr and fcu transfers rely on intact pl if pl not there fds iv to epl radial nerve transfer superficialis transfer pt to ecrb fds iii to edc fds iv to epl and eip fcr to apl and epb violates one tendon one function maybe too powerful work capacity fds 4. Peroneal tendon repair please note these are general guidelines and may change for various reasons on a casebycase basis. The patient underwent static and dynamic splinting and a modified tendon transfer protocol starting at 3 weeks and ending at 16 weeks postsurgery.

Rehabilitation protocol general principles this protocol for achilles tendon repair is designed to provide the rehabilitation professional with a general guideline for patient care with the alterg antigravity treadmill. Primary upper extremity and hand extensor tendon repair protocol this protocol is not intended to be a substitute for ones clinical decision making regarding the progression of a patients postoperative course based on their physical examfindings. Pre and post operative management in tendon transfer. Sports medicine physical therapy rehabilitation protocols. Pdf rehabilitation of the elbow extension with motor. Create strong insertion tendon tendon or tendon bone to maximize mobilization 6. A comparative study on tendon transfer surgery in patients with. David chen supportive, knowledgeable and proactive regarding tendon transfer procedures for persons with tetraplegia monthly tendon transfer clinic with an interdisciplinary and multi. This protocol provides you with general guidelines for initial stage and progression of rehabilitation according to specified time frames, related tissue tolerance and directional preference of movement.

And this can lead to additional problems of contractures and deformity. Maintain rom of uninvolved joints shoulder, wrist, hand. General post operative management rehabilitation is equally important in tendon transfer success as surgical execution rehabilitation physiotherapy is essential in regaining joint mobility lost during splinting training tendon to glide in new course teaching patients to activate a new muscle to achieve a certain function. Tendon transfer surgery to augment hand function lost to spinal cord injury sci has gained acceptance as a rehabilitation option for adults but has yet to be fully explored in children. Successful rehabilitation following eip to epl tendon transfers requires the guidance of a highly trained hand therapist. A tendon transfer is a surgery that moves a working muscle and tendon to replace a nonworking muscle and tendon. Outcomes of tendon transfer surgery and occupational. Gentle active forearm pronationsupination and wrist exionextension. Reverse total shoulder arthroplasty with latissimus dorsi tendon transfer protocol. For example, after a broken wrist, the tendon to the thumb epl tendon that allows you to make a thumbsup can break.

Common peroneal nerve palsy leading to foot drop is difficult to manage and has. A tendon transfer procedure relocates the insertion of a functioning muscle tendon unit mtu in order to restore lost movement and function at another site. A tendon transfer is a surgical procedure in which a healthy tendon is. Pdf tailoring tendon transfer surgery and rehabilitation for a. This issue also has been resolved as contemporary techniques attempt to approximate the pectoralis tendon into direct contact with the scapula and use the graft only to reinforce the repair. Rehabilitation protocol for achilles tendon repair this protocol is intended to guide clinicians and patients through the postoperative course for an achilles tendon repair. Tibial tubercle transfer and lateral release department of orthopaedic surgery. Rehabilitation of the elbow extension with motor imagery in a patient with quadriplegia after tendon transfer. A classic loss is rupture of the extensor pollicis longus epl.

Tailoring tendon transfer surgery and rehabilitation for a. Postsurgical rehabilitation guidelines for the orthopedic clinician. Lower trapezius tendon transfer physical therapy protocol dr. The success of muscle transfer in the treatment of the brachial plexus palsy required the surgeons specialization, the patients motivation, and a rehabilitation program. The therapist promotes motor retraining of the transferred tendon and treatment to control scarring and edema to regain normal function of the thumb. A tendon transfer is moving a tendon from its normal, anatomic location to another area of the foot or ankle. Postoperative physical therapy management of tendon transfer for.

Tendon transfers may be used for muscles or tendons destroyed by injury or disease fig. Extended delay in the treatment of radial nerve injuries might lead to permanent loss of motor endplate function. The polio epidemics that occurred in 19 th century europe contributed to the development of tendon transfer procedures. The uninjured fingers in orthosis dynamically assist finger extension that unloads the tendon repair. Achilles tendon repair rehab protocol below we outline the steps that we have our patients take to recover from achilles tendon repair surgery. Flexor hallucis longus tendon transfer in treatment of. We provide our patients with comprehensive, coordinated care from experts who understand the unique needs of women in sports. Left and right arrows move across top level links and expand. The patient attended therapy 1 to 3 times a week, depending on protocol stage and need for skilled therapy intervention. In this study, hand function and performance of activities of.

Rehabilitation guidelines for achilles tendon repair. Postoperative management of flexor tendon injuries. In general this is 3 to 4 weeks to allow for tendon healing 41. They involve the same basic concept as all reconstructive surgery. Treatment of peroneal nerve injuries with simultaneous tendon transfer and nerve exploration bryant ho1, zubair khan2, paul j switaj1, george ochenjele1, daniel fuchs1, william dahl2, paul cederna3, theodore a kung3 and anish r kadakia1 abstract background. Flexor tendon repair therapy protocol 7 of 5 jeme cioppamosca, j. Dissection is brought down to the posterior tibialis tendon. As such, it should be stressed that this is only a protocol and should not be a substitute. Tendon transfer surgery for people with tetraplegia.

The purpose of this case report is to describe the physical therapy postoperative management of a patient who underwent a multiple tendon transfer to correct the loss of digitalwrist extension of the right upper extremity. The intent of this protocol is to provide the physical therapist with a guidelinetreatment protocol for the postoperative rehabilitation management for a patient who has undergone a reverse total. Early active mobilization of tendon transfers santosh rath repub. Posterior tibial tendon transfer protocol surgical overview.

Overall, transfer of the sternal head of the pectoralis major tendon is a successful procedure to address painful scapular. A keyhole is made in the groove of the humerus, the tendon mass is then inserted into the keyhole and pulled downward so that the tendon mass is locked in place. We present a case of a musician with unique demands to demonstrate the option to customize surgical technique and therapy regimen to the unique needs of each patient. The sports physical therapy service is an integral part of the sports medicine center and the department of. Pre and postoperative therapy following tendon transfer surgery. Tendon or muscle transfers restore balance to a hand crippled by loss of muscle function. One year later, transfer of the trapezius muscle was performed to stabilize the shoulder. Madison, wi 53718 rehabilitation guidelines for achilles tendon repair the achilles tendon is the strongest and thickest tendon in the body. Flexor tendon repair therapy protocol sideline orthopedics. Lower trapezius tendon transfer physical therapy protocol. Tendon transfer is the transfer of the power of an innervated muscle to a denervated or weaker muscle or muscles by way of transfer of its tendinous insertion.

Compared with the suture group, the screw group had higher mean ultimate load values 3. Genesis birth palsy cerebral palsy polio world war goal principles of tendon transfer focus on radial nerve transfers specific transfers for. Surgical reconstruction and rehabilitation in leprosy and. Strategies for success working with tendon transfer patients can be a challenging yet an extremely rewarding experience. Pdf tendon transfers in hand patients are a commonly performed procedure after extensor tendon rupture. Insert distance away from joint to improve power at expense of decreased excursion 5. Tendon transfers in hand patients are a commonly performed procedure after extensor tendon rupture. Tendon transfer rehabilitation exploring hand therapy. You may learn more about how the stone clinic repairs achilles tendon ruptures without open surgery in our explanation of achilles tendon injury, diagnosis and.

It attaches the calf muscles soleus and gastrocnemius to the heel bone calcaneus. Specific intervention should be based on the needs of the individual and should consider exam findings and clinical decision making. The process of tendon transfers offers a rebalancing of the hand by. Principles of tendon transfers for persons with tetraplegia. Shoulder reverse tsa with latissimus dorsi transfer. Finger rehab is dictated by tendon repairs transfers performed if these were done. Eichinger md the intent of this protocol is to provide the physical therapist with a guidelinetreatment protocol for the postoperative rehabilitation management for a patient who has undergone a lower trapezius tendon transfer lttt for an irreparable rotator cuff tear.

The posterior tibialis is the main dynamic stabilizer of the hindfoot. Rehabilitation o rest in plaster splint intermediate phase 26 weeks goals o control pain o protect surgical repair rehabilitation o change into scaphoid brace. A curvilinear incision is made in the usual fashion around the medial malleolus. Yoke orthosis links the uninjured fingers to the repaired finger.

Find pdfs of our most common rehabilitation protocols. Tendon grafting can be performed with a palmaris longus or toe extensor. However, the standard side to side technique is not applicable in every patient. References wheelock margie md, nerve transfers for treatment of isolated axillary nerve injuries, plast surg 2015 vol. The surgeon should apprise the therapist of the quality of the repair, the type of repair, alterations in tendon length, the integrity of the tissue, the status of surrounding tissues, and any additional. Tendon should insert around joint at 90 degrees to maximize power and excursion 4. In hunter et al rehabilitation of the hand and upper extremity, mosby, 449, 2002. Treatment of peroneal nerve injuries with simultaneous. Grip strengthening can be started at 4 weeks in the splint. Brigham and womens hospital a teaching affiliate of. Based on studies indicating that early motion increases repair strength, most published protocols start motion at 24 to 48 hours after surgery. Department of rehabilitation services physical therapy primary extensor tendon repair protocol edc, eip, edq, epl, ecrl, ecrb, ecu the intent of this protocol is to provide the clinician with a guideline for the postoperative rehabilitation course of a. Gallandkirby posterior tibial tendon reconstruction fdl transfer and calcaneal osteotomy postsurgical rehabilitation protocol postop days 1 28 immobilized in equinus and varus crutches non weight bearing nwb active range of motion arom hip and knee wiggle toes straight leg raises slr x 4 directions short arc quad saq. Peroneal tendon repair south carolina sports medicine.

Gallandkirby posterior tibial tendon reconstruction fdl transfer and calcaneal osteotomy postsurgical rehabilitation protocol postop days 1 28 immobilized in equinus and varus crutches non weight bearing nwb active range of motion arom hip and knee wiggle toes straight leg raises slr x 4 directions. Tendon transfer surgery was performed to improve wrist, hand, and digital extension. The goal is to restore movement to a foot and ankle that has lost function. A tendon transfer can be used to restore grasp, improve the position of the hand in space, and to prevent deformity, dislocations and contractures.