 Additional muscle deficits can contraindicate tendon transfer, namely the serratus anterior muscle or the muscles-to-be-transferred themselves.Serratus anterior muscle deficit is another cause of scapular winging and decreases the efficacy of an Eden-Lange procedure, but it can be overcome with a simultaneous pectoralis major transfer.Muscular dystrophy often contraindicates tendon transfer, because the muscles transferred are either dystrophic or capable of becoming dystrophic.