Many people with HSAN1 experience contractures of muscles and tendons in the fingers. Paul Clemow is happy to report that the surgery he had on his hands is helping him to regain flexibility in his fingers. He is working hard on strengthening his grip.
His surgeon, Dr. Joshua S. Gluck, explains the procedure this way, starting with “a brief anatomy lesson: each finger has two flexor tendons, one to bend the tip and one to bend the middle. The tendon to bend the tip is a bit more important/ useful because it can also bend the middle. So, if you cut the tendon to the middle, you lose a bit of grip power, but everything still works.
“The surgery we did cut the flexor tendon to the middle of the finger (called flexor digitorum superficialis) and reattached it to the longer tendon to the tip (flexor digitorum profundus). This procedure is referred to as an “FDS to FDP transfer”. It essentially sacrifices the tendon to the middle of all four fingers in order to gain length of the tendon going to the tip. It’s generally a surgery used for hand and forearm spasticity, especially in patients with cerebral palsy.”