Tendon Transfers of the Shoulder, Elbow, Wrist, and Hand

Peripheral nerve and brachial plexus injuries are life-altering events, given the extensive compromise in shoulder, arm, and hand function. When these injuries do not recover, or attempts at nerve reconstructions fail to restore various functions of the upper extremity, patients are often left quite limited in their daily lives. Tendon transfers have been established in the hand and wrist as very successful options for many patients with peripheral nerve injuries isolated to one specific nerve or motor distribution. In recent years, tendon transfers around the shoulder and elbow have shown tremendous promise in restoring function what was traditionally very hard to treat proximal peripheral nerve lesions or upper trunk brachial plexus injuries. There are many important considerations when deciding on the appropriate tendon transfer option for these patients. Keeping these considerations in mind, we will review various types of shoulder, elbow, and hand functional deficits and the various tendon transfer options to reconstruct each one.