Tendon Transfer Surgery: Focus on….

Median and Ulnar nerve palsy is a devastating condition that compromise hand function. A procedure of tendon transfer may be helpful to restore the movements by linking palsy muscles to other muscles able to contract. Scientific discoveries and technological innovations have profoundly changed this kind of surgery; studies on sarcomeres, for example, changed the concept of tensioning. To date we know that muscle strength and its contraction capacity depends on many factors (not only tensioning) such as sarcomeres length, cellular cytoskeleton and extracellular matrix composition: all of these factors interact together and in a ways not still fully understood, determining the complex concept of "movement." Technology made possible the production of smaller and more complex prostheses so to open new frontiers for modulation of the tendon length during grasping. These devices, currently studied on computer models, on cadaver or on animals, behaved great impetus to research but are still not suitable for implantation in humans. Challenges are still numerous: for example obtain more biocompatible implantable device, find new surgical approach, new ways to obtain better results for this kind of patients.