Tendon repair stitches together a cut or torn tendon so the joint it moves works again; tendon transfer reroutes a working muscle-tendon unit to replace movement lost through nerve injury or paralysis. Both help restore hand and arm function after injuries, rheumatoid arthritis ruptures or irreparable nerve damage.
- AnaesthesiaRegional (arm block) or general
- DurationTypically 1 to 3 hours
- Hospital stayUsually day care to 1 day
- Back to routineProtected use for 6 to 8 weeks; heavy use typically after about 12 weeks
What is tendon repair and tendon transfer?
A tendon is a tough band of fibrous tissue that connects muscle to bone and allows a joint to move. When a tendon is cut, the movement it controls is lost. Most hand tendon injuries come from cuts through the skin, such as accidents with glass or knives, assaults, road traffic and industrial accidents, household accidents and self-inflicted wounds.
Tendon repair surgically rejoins divided or torn tendons using special sutures to restore function and joint movement. Tendons can tear straight across, at an angle, or pull off the bone. When an injury is severe, presents late or leaves a large gap, a tendon graft, usually from the foot or another part of the body, may be used.
Tendon transfer is a planned (elective) operation that moves a working muscle-tendon unit to a new attachment to replace lost movement and stability. The muscle keeps its origin, nerve and blood supply; only its tendon insertion is moved, so its action changes. It is used after nerve injuries that will not recover, or after loss of a muscle-tendon unit.
Who is tendon repair and tendon transfer for?
- Cut tendons in the hand, wrist or forearm (flexor or extensor tendons)
- Tendon ruptures from rheumatoid arthritis
- Contact-sport tendon injuries, most often at the elbow, knee and ankle
- Muscle paralysis from nerve injury, root avulsion or nerve injuries that did not recover after grafting (tendon transfer)
- Failed nerve transfers or muscles that can no longer be reinnervated (tendon transfer)
How is it done?
- Acute tendon injuries are repaired as emergencies after blood tests, X-rays and an anaesthesia assessment
- The tendon ends are found and repaired under magnification with gentle handling; injured nerves and vessels are repaired at the same time
- A tendon graft is used if a segment is lost
- Tendon transfer: the tendon is detached from its bone insertion and attached to a different bone or tendon, then a splint is applied
- Before an elective transfer: review medicines, stop aspirin-type drugs if advised, and follow fasting instructions
What is recovery like?
- Tendon repairs typically take 8 to 12 weeks to heal, with joint movement returning gradually
- Elevate the limb for a few days and keep the splint or cast clean and dry
- Supervised hand therapy with a protective splint is essential to prevent rupture and stiffness
- After a tendon transfer, a splint is usually worn for at least a month and heavy loading avoided for at least 6 weeks
- Therapy retrains the transferred muscle for its new role
What are the risks?
- Rupture of the repaired tendon, often linked to using the hand too early
- Tendon adhesions (scarring) that may need a later release (tenolysis)
- Joint stiffness or reduced tendon movement
- Bleeding and infection at the surgical site
Why choose Dr. Jithendran?
- Dual training in orthopaedics (MS) and plastic surgery (MCh, DNB), with hand and microsurgery experience from Ganga Hospital, Coimbatore
- Consults at five hospitals across Bengaluru, with 24×7 availability for emergencies
- Clear explanations in English, Tamil, Hindi and Telugu, and time to answer every question
- Strict sterilisation and patient-privacy standards
Frequently asked questions
How long does a hand tendon take to heal?
Repaired tendons typically take 8 to 12 weeks to heal strongly. During this time a protective splint and a structured hand therapy programme are used to keep the tendon gliding without overloading the repair. Full strength and movement may continue to improve for several months.
What happens if a cut tendon is not repaired?
The finger or joint the tendon controls will not move properly, and the muscle and tendon end retract over time. Late repair is more difficult and may require a tendon graft or a staged reconstruction, so cut tendons are best repaired early, usually within days of the injury.
What is the difference between tendon repair and tendon transfer?
Tendon repair rejoins the ends of a damaged tendon so it works as before. Tendon transfer moves a healthy, working tendon to a new attachment to take over the job of a muscle that has been paralysed or lost, for example after an irreparable nerve injury.
Can a repaired tendon rupture again?
Yes, rupture is one of the main risks, especially if the hand is used forcefully before the tendon has healed. Following the splinting and therapy instructions closely, and avoiding gripping or lifting until your surgeon allows, greatly reduces this risk.
