Our Summary

When people hurt the soft tissues in their hands, specifically their tendons, doctors can either directly repair those tendons or use tendon grafts. The most common tendons used in these grafts come from the muscles in the palm and foot. However, these aren’t always the best options because they might not be present or suitable for this kind of surgery. In this paper, the authors suggest using tendons from a thumb muscle, the abductor pollicis longus, for these grafts instead. This muscle is a great choice because it’s easy to extract, doesn’t cause much damage to the donor site, and can be used when the common palm tendon isn’t present.

FAQs

  1. What are the common sources of tendons used for grafts in hand surgery?
  2. Why might the tendons from the palm and foot not be suitable for grafting in hand surgery?
  3. Why do the authors suggest using the abductor pollicis longus thumb muscle for tendon grafts?

Doctor’s Tip

Additionally, it’s important for patients undergoing a hand transplant to follow a strict rehabilitation program to regain strength and function in their new hand. This may include physical therapy, occupational therapy, and regular follow-up appointments with your healthcare team. It’s also important to take any prescribed medications, attend all appointments, and communicate any concerns or changes in symptoms with your healthcare provider. Remember to be patient and give yourself time to adjust to your new hand.

Suitable For

Patients who may be recommended for a hand transplant include those who have lost one or both hands due to trauma, burns, infections, or congenital conditions. These individuals may have limited function in their hands and may benefit from a hand transplant to improve their quality of life and regain some level of hand function.

Candidates for hand transplant surgery are carefully evaluated by a team of healthcare professionals, including hand surgeons, transplant surgeons, psychiatrists, and physical therapists. They must be in good overall health, have realistic expectations about the surgery and rehabilitation process, and be committed to following a strict medication regimen to prevent rejection of the transplanted hand.

It is important to note that hand transplants are complex, high-risk procedures with potential complications, including rejection of the transplant, infection, and the need for lifelong immunosuppressive medication. Patients considering a hand transplant should thoroughly discuss the risks and benefits with their healthcare team before making a decision.

Timeline

Before a hand transplant, a patient would typically undergo extensive medical evaluations to determine if they are a suitable candidate for the surgery. This would include assessing their overall health, psychological readiness, and potential risks and benefits of the procedure.

During the hand transplant surgery, the patient would undergo anesthesia and the donor hand would be attached to the recipient’s arm. The surgery can take several hours to complete.

After the surgery, the patient would need to undergo extensive rehabilitation and physical therapy to regain function and strength in their new hand. This process can take several months to years, depending on the individual and the success of the transplant.

Overall, the timeline for a hand transplant can vary depending on the individual and their specific circumstances. It is a complex and challenging procedure that requires significant commitment and dedication from both the patient and their medical team.

What to Ask Your Doctor

  1. What are the risks and potential complications associated with a hand transplant surgery?
  2. How long is the recovery process after a hand transplant surgery?
  3. What kind of rehabilitation and physical therapy will be required after the surgery?
  4. How will a hand transplant impact my daily activities and quality of life?
  5. Are there any long-term effects or considerations to keep in mind after receiving a hand transplant?
  6. How successful are hand transplants in general, and what is the success rate at your facility?
  7. What is the process for finding a suitable donor for a hand transplant?
  8. How will my body react to the transplanted hand, and what kind of immunosuppressive medications will I need to take?
  9. Will I need additional surgeries or follow-up procedures after the initial hand transplant surgery?
  10. What support and resources are available for patients undergoing a hand transplant surgery?

Reference

Authors: Rosas S, Mesa C, Mesa F. Journal: J Hand Surg Am. 2017 Mar;42(3):e205-e208. doi: 10.1016/j.jhsa.2016.12.006. Epub 2017 Jan 11. PMID: 28089162