Name of the Procedure:

Transplant or transfer (with muscle redirection or rerouting), thigh (e.g., extensor to flexor); single tendon

Summary

This surgical procedure involves transferring or rerouting a muscle tendon in the thigh to improve its function. Specifically, it redirects an extensor muscle to perform the role of a flexor muscle.

Purpose

This procedure addresses issues related to muscle imbalance or damage in the thigh, often caused by injury, nerve damage, or certain medical conditions. The goal is to restore muscle function and improve mobility and strength.

Indications

• Chronic muscle weakness or paralysis in the thigh.
• Nerve injuries that affect muscle function.
• Conditions like cerebral palsy or stroke that cause muscle imbalances.
• Inadequate response to non-surgical treatments such as physical therapy.

Preparation

• Patients may need to fast for several hours before the surgery.
• Adjustments to current medications, particularly blood thinners.
• Preoperative imaging (e.g., MRI or ultrasound) and assessments to plan the surgery accurately.

Procedure Description

1. Anesthesia is administered to ensure the patient is comfortable and pain-free.
2. A surgical incision is made in the thigh to access the targeted muscle and tendon.
3. The surgeon detaches the tendon of an extensor muscle.
4. The tendon is then rerouted and attached to a location where it can function as a flexor muscle.
5. The incision is closed with sutures or staples, and a dressing is applied.

Duration

The procedure typically takes 1 to 2 hours but may vary depending on the complexity of the case.

Setting

The surgery is usually performed in a hospital or a surgical center.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurses
• Physical therapists for postoperative care

Risks and Complications

• Infection at the surgical site
• Blood clots
• Nerve damage
• Limited success in restoring full function
• Pain or discomfort during recovery

Benefits

The expected benefits include improved muscle function, increased mobility, and better quality of life. Patients may begin to notice improvements within weeks as they start rehabilitation.

Recovery

• Postoperative instructions include rest and limited movement of the thigh.
• Analgesics for pain management.
• Physical therapy to aid in the recovery and strengthen the re-routed muscle.
• Full recovery and return to normal activities may take several weeks to months.

Alternatives

• Physical therapy and strengthening exercises.
• Use of braces or orthotic devices.
• Other surgical options like more extensive muscle-tendon transfers.

Patient Experience

During the procedure, the patient will be under anesthesia and should not feel any pain. Post-surgery, there may be discomfort and pain managed through medications. Rehabilitation and physical therapy are critical in the weeks following surgery, and patients should follow their care team's instructions closely to maximize recovery outcomes.