Therapist's management of tendon transfers.

Rehabilitation of the tendon transfer patient is a challenge to the hand therapist, given the variety of transfers performed and the level of skill, knowledge, and creativity needed to treat them adequately. Careful preoperative evaluation and treatment increase the prospects for a successful result. The postoperative care of the tendon transfer is a team effort by the surgeon, therapist, and patient; each must have a clear understanding of the goals and precautions of each stage of treatment. Restrictions are initially placed upon the patient's mobility to allow healing; these are then reduced as he activates the transfer and then begins to incorporate the new motion into daily activity. Resistance is added gradually to the patient's tolerance, and care is taken throughout the rehabilitation process not to overwork the muscle in its new function. Tendon transfer is never completely restorative, but often makes a striking difference in the patient's functional abilities. The outcome can be very gratifying for the patient and for those who collaborate in his treatment.