Tendon Transfer

These three pencil images by James Henderson depict a standard tendon transfer procedure and are intended as an educational aid for aspiring hand surgeons.

The first image shows a standard view of the back of a left hand and a projection of the sub-surface extensor tendons, which pull and hold the fingers out straight. The main extensor tendon to the thumb, the “extensor pollicis longus” is ruptured, or broken. The second and third images demonstrate how its function may be restored. The additional extensor tendon to the index finger, the “extensor indicis proprius”, is re-routed and joined by a weave and sutures to the thumb tendon. This can be achieved through the three small longitudinal incisions also depicted. The index and little fingers have additional extensor tendons, powered by separate muscles which can be used in this way without affecting the function of their original finger.