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Evidence. Clarity. Practice.

© 2026 OrthoVellum. For educational purposes only.

Not medical advice. Verify clinically important information against current local guidance.

Back to Research
Level VMust KnowHand & Upper LimbExpert Opinion

Evidence brief

Tendon Transfer Principles

Tendon Transfer Principles in the Upper Extremity

Authors
Brand PW
Journal
Clinical Mechanics of the Hand
Year
1985

Key Findings

  • 1

    Donor must be expendable and strong enough

  • 2

    Similar excursion to replaced tendon

  • 3

    Straight line of pull optimal

  • 4

    Single tendon for single function

  • 5

    Synergistic transfers preferred

Clinical Implications

Tendon transfers can restore function after nerve injury or muscle loss. Understanding biomechanical principles ensures appropriate donor selection and optimal outcomes.

Teaching Note

Know Brand's principles: strength (one grade loss expected), excursion (wrist 33mm, fingers 70mm), straight line pull, synergy. Common transfers: PT to ECRB (radial nerve), FCR to EDC (high radial), FDS to intrinsics (low ulnar). Know the donor characteristics.

Citation

Brand PW, Hollister A. Clinical Mechanics of the Hand. 3rd ed. St. Louis: Mosby; 1999.

Evidence Level

V

Level V

Expert opinion or mechanism-based reasoning

Topics

tendon transferparalysisreconstructionprinciples

Related Topics

  • Tendon Transfer
  • Radial Nerve Palsy
  • Ulnar Nerve Palsy

External Links

Related Papers

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Nerve Repair Evidence

Mackinnon SE (1988)

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Shi Q (2011)

III

Zone II Flexor Tendon Repair

Strickland JW (1980)

I

Scaphoid Fracture Evidence

Buijze GA (2010)