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At least 19 recordsLinked to original sources
PubMed1979

Determination of muscle-tendon unit properties during tendon transfer.

Data on passive lengthening and active shortening from electrical stimulation to give a total functional excursion are presented. Length-tension characteristics of certain muscles used for transfer are given. Electrical stimulation of the newly transferred tendon gives useful information that is reproducible. This new knowledge obtained at operation is an important adjunct to the traditional techniques and provides helpful information in performing better procedures.

Adult↗
PubMed1991

[Development of the techniques of tendon transfers for radial paralysis].

The techniques of tendon transfer for radial palsy are continually evolving. The technique of R. Merle d'Aubigné partly inspired by that of Robert Jones clearly represented an advance, but a study of the results has shown several imperfections. The techniques of Brand, Tsuge, or Boyes more recently, have also brought improvements, but are not entirely satisfactory. A study of all the elements of tendon transfers schemes leads us to describe two basic schemes for tendon transfers either using F.C.U. or not, which can be adapted to the patient's particular needs. The essential point for success is the centralization of extensor carpi radialis longus at its insertion.

Hand↗
PubMed1991

Combined split anterior tibial-tendon transfer and intramuscular lengthening of the posterior tibial tendon. Results in patients who have a varus deformity of the foot due to spastic cerebral palsy.

Twenty patients who had a varus deformity of the foot secondary to spastic cerebral palsy had twenty-two operations involving combined split anterior tibial-tendon transfer and intramuscular lengthening of the posterior tibial tendon, with and without concomitant lengthening of the Achilles tendon. Preoperatively, all patients had had a dynamic varus deformity of the hindfoot and adduction of the forefoot in both the stance phase and the swing phase of gait. At an average follow-up of 6.2 years (range, 2.3 to 8.8 years), there were fourteen excellent, four good, and four poor clinical results. Two patients who had a fixed varus deformity of the hindfoot and one patient who had a very weak anterior tibial muscle had a poor result. We concluded that the combined procedure is effective for correction of a flexible varus deformity of the foot in patients who have spastic cerebral palsy.

Adolescent↗
PubMed1991

Tendon transfers in traumatic foot.

A clinical review was performed of 11 cases of traumatic foot treated by tendon transfer. Among 11 patients, there were eight males and three females, ranging from four to 36 years of age. The anterior tibial tendon was used in six cases for tendon transfer and among these, split anterior tibial tendon was used in three cases in children. The posterior tibial tenodn was used in two cases and the extensor digitorum longus tendon of the foot was in three cases. In six cases of soft tissue injury where tendon transfer was impossible, microvascular free cutaneous flap transplantation was combined with the tendon transfer. Follow-up results were obtained from 25 months to nine years. Excellent results were obtained in eight cases and satisfactory results in three cases. For the correction of function loss in traumatic foot, tendon transfere were a useful method for the recovery of active motion of the foot. For the restoration of function loss in the traumatic foot, there are several methods of treatment such as tendon transfer, arthrodesis and tenodesis, but for recovery of the active motion of the foot, tendon transer is the only useful method.

Adolescent↗
PubMed1975

[Restoration of grip by means of repair of the injured peripheral nerve and/or muscle-tendon transfer (author's transl)].

Muscle or tendon transfers are indicated after lesions of peripheral nerves if regeneration does not occur or remains incomplete after nerve repair or if the paralyzed muscles themselves are damaged. In long-standing cases the authors try nerve repair to attain adequate sensitivity, and perform the tendon transfer independently. The different techniques are discussed; transfer of the brachialis muscle to replace deficient flexor muscles is described and nerve-into-muscle implantation is mentioned.

Brachial Plexus↗
PubMed1979

The role of muscle reeducation in dynamic tendon transfer surgery of the hand.

Tendon transfers are used commonly to improve function following damage to major nerve trunks. For the transfer to function dynamically and in harmony with other active hand muscles, proper integration of the action of the transfer into the available hand movements is essential. This concept is discussed together with the rationale and methods of pre and postoperative training that contribute immensely to the success of such operative procedures.

Body Image↗
PubMed1976

Early tendon transfer for radial nerve transection.

A retrospective comparison of twelve patients with radial nerve transection treated by nerce repair, and thirteen similar patients treated by tendon transfer only, showed an average time to recovery of 7.5 months after nerve repair, and eight weeks after transfer. In view of this, a policy of early tendon transfer instead of radial nerve suture is advised. Results are reported in nine patients who had tendon transfers at an average of thirteen days after nerve injury.

Adult↗
PubMed1975

Tendon transfers to improve grasp in patients with cervical spinal cord injury.

Patients with cervical spinal cord injury can gain useful hand function from a good rehabilitation programme and non-operative hand care. Effective prehension can usually be achieved by proper positioning, exercises, and splinting but when grasp is poor, tendon transfers are very effective in furthering the goal of independence. These patients have been reviewed extensively and classified into groups according to remaining neurological function. Group I patients have weak elbow flexion and weak shoulder function or less. No tendon transfers were done. Group II patients have shoulder control, elbow flexion and weak wrist extensors. Some of these patients can be improved by transferring the brachioradialis to the radial wrist extensor. Group III patients have the above and good to normal brachioradialis and two radial wrist extensors. Transferring the brachioradialis to restore opposition and the extensor carpi radialis longus to the flexor digitorum profundi provides strong and effective prehension. Group IV patients have the above plus pronator teres and flexor carpi radialis which can be used for transfer. Opposition and finger flexion can be restored by a variety of transfers. In groups III and IV tendon transfers were done only when automatic grasp was poor or absent. If finger grasp was good and thumb function ineffective only opponens transfers were done in order to achieve key pinch. Group V patients have all muscles functioning but with varying degrees of intrinsic weakness. Opponens transfer is useful for these patients. Indications and contraindications to surgery are given. All the patients have improved function and strength following their tendon transfers. No patient has regretted having had surgery.

Adolescent↗
PubMed1977

Preoperative and postoperative dynamic electromyography as an aid in planning tendon transfers in children with cerebral palsy.

Electromyography was used to supplement clinical evaluation in planning tendon transfers in twenty-four children with cerebral palsy. Sixteen flexible deformities of the hind part of the foot, four internally rotated lower limbs, and four flexible deformities of the forearm and wrist were studied. When deforming muscles were active exclusively in one portion of either the gait cycle or a function of an upper extremity, appropriate tendon transfers were performed. When continuous muscle activity was noted, tendon lengthening was utilized. The desired function was obtained in all twenty-four patients six months after operation.

Cerebral Palsy↗
PubMed1991

Extensor digiti minimi tendon transfer to correct abducted small finger in ulnar dysfunction.

A tendon transfer to correct the abducted posture of the small finger in patients with ulnar nerve dysfunction is described. The extensor digiti minimi is transferred deep to the extensor digitorum communis tendon or junctura tendinae to the small finger and inserted into the radial portion of the extensor hood, correcting the muscle imbalance. Successful results in 10 patients are reported.

Female↗
PubMed1991

[Traumatic partial paralysis caused by injury of the R. profundus nervi radialis. Nerve reconstruction and tendon transfer surgery].

Traumatic lesion of the deep branch of the radial nerve (posterior interosseous nerve) causes paralysis of the finger and thumb extension while wrist extension is maintained. There is no sensory disturbance. The lesion can be caused by knife injury, by Monteggia lesions and iatrogenically by procedures at the proximal radius. Traumatic disconnection of the posterior interosseous nerve is a good indication for early surgical exploration of the nerve; microsurgical reconstruction should then be carried out. When nerve repair has not been done or has been unsuccessful, finger and thumb extension can be achieved by various methods of tendon transfer. No transfer is necessary for the wrist. In two cases with fresh discission of the deep branch of the radial nerve (one after knife injury and one due to plate osteosynthesis of the radius) a microsurgical reconstruction was done. In two other cases with an old lesion after procedures on the proximal radius and unsuccessful nerve reconstruction a tendon transfer was done. In the two cases of acute microsurgical intervention the recovery was complete. In the two cases of tendon transfer good restoration of the finger and thumb extension was achieved.

Adolescent↗
PubMed1991

Analysis of donor deficit after extensor indicis proprius tendon transfer.

From November 1984 to February 1989, 13 extensor indicis proprius tendon transfers were performed for various reasons. Nine patients with a total of ten transfers were available for follow-up, at an average of 29 months. Active range of motion was measured (both dependently and independently) at the metacarpophalangeal joints of both the involved and the uninvolved index finger. There was no extensor lag of the metacarpophalangeal joint during dependent extension, and only an average of 2.1 degrees of extensor lag during independent extension. Measurement of total active motion showed that the dependent and independent range of motion of the involved index finger was 95% of that of the uninvolved index finger. The obvious concerns with using the extensor indicis proprius tendon for transfer is the possible theoretical loss of complete extension and independent extension of the index finger. We found these concerns not to be a problem.

Humans↗
PubMed1978

[Indicis tendon transfer. technique and results (author's transl)].

We examined 38 patients out of 41 with indicis tendon transfer, performed at the Department for Hand Surgery of the University of Munich during the past eight years; the patients had suffered a subcutaneous rupture or an open traumatic separaton of the extensor pollicis longus tendon. In five cases the function fo the operated had was found deteriorated by other causes. Of the remaining 33 patients 26 showed an excellent function and five patients a good function of the operated thumb. Deficient functional results were discovered with two patients. Almost in all cases extension of the index finger was found reduced in force; none of the patients, however become aware of it. In performing the tendon anastomosis care must be taken to apply proper tensions to the tendons joined.

Adult↗
PubMed1990

Tendon transfer for radial nerve palsy.

Fifty patients (42 males and 8 females) with radial nerve paralysis were treated by tendon transfer. The age range was 20-50 years, and the follow-up period was 2-12 years. The right hand was affected in 39 cases; the left hand in 11. Forty-three of the 50 cases had high radial nerve palsy and 7 had low radial nerve palsy. Irreparable damage to the radial nerve associated with severe humeral shaft fracture was encountered in 38 cases; a penetrating stab wound was the cause in 7 cases; and 5 cases were found as a result of full recovery from brachial plexus palsy. The pronator teres was transferred to the extensor carpi radialis longus and brevis in 43 patients, the flexor carpi ulnaris to the extensor digitorum communis in 40 patients, and the flexor digitorum superficialis of the fourth finger to the extensor digitorum communis in 10 patients. The palmaris longus was transferred to the extensor pollicis longus in all 50 cases. The results of the surgery were excellent in 12 cases, good in 31, and fair in 7. Five cases had mild radial deviation of the hand without disturbance of hand function.

Adult↗
PubMed1979

Prevention of extensor lag after indicis proprius tendon transfer.

An experiment on fresh cadaver hands showed that a longitudinal incision of the hood did not affect index extension when traction was made on the common extensor tendon, but that excision of a portion of the hood containing the indicis proprius caused an extensor lag. The lag was eliminated by repair of the hood, providing that the closure was not too tight to prevent normal excursion of the hood. These findings were correlated with findings in patients who had undergone indicis proprius tendon transfer. Extensor lag after indicis proprius transfer is not caused by removal of the force of the tendon per se, but by factors which cause either disruption of normal hood function or tethering of its normal excursion.

Cadaver↗
PubMed1978

Tendon transfers for radial nerve palsy: use of superficialis tendons for digital extension.

Since 1959, 22 patients have had wrist extension restored by transfer of the pronator teres to the extensor carpi radialis longus and brevis, common finger extension by transfer of the superficialis of the long finger, independent thumb and index finger extension by transfer of the superficialis of the ring finger, and abduction of the thumb by transfer of the flexor carpi radialis at the wrist joint level. Twenty-one of 22 patients have been evaluated from 8 months to 15 years after operation, with an average follow-up of 4.5 years. By our new system of evaluation, there were 10 excellent results, six good results, five fair results, and all patients improved. Sixteen patients obtained full, independent thumb-index finger extension, three had fair function, and two obtained thumb-index extension by tenodesis of the transfer. This procedure allows full metacarpophalangeal extension independent of wrist position, provides thumb-index finger extension independent of the ulnar three digits, and maintains the dorsal-radial-to-volar-ulnar plane of functional motion of the wrist by retaining the flexor carpi ulnaris.

Adolescent↗
PubMed1992

How musculotendon architecture and joint geometry affect the capacity of muscles to move and exert force on objects: a review with application to arm and forearm tendon transfer design.

This commentary reviews musculotendon architecture and the relation between architectural parameters and the force, speed, and excursion capacity of musculotendon units. It is hoped that this review will help provide the framework within which to appreciate the importance of the data presented by Lieber et al. Muscle fiber pennation hardly affects musculotendon output of forearm and hand muscles. Instead, physiologic cross-sectional area and muscle fiber length affect force capacity and speed and excursion capacity, respectively. How muscles with equal mass can have different force, speed, and excursion capacities is explained. Since the moment arm of a muscle (the shortest distance from the musculotendon unit to the joint center of rotation) transforms muscle output into musculotendon output, it is shown why the capacity for a muscle to exert force on an object, as during grasping, is directly proportional to its moment arm and why the range of joint movement and speed over which muscles exert force is inversely proportional to the moment arm. Finally, tendon, being not stiff in forearm and hand musculotendon units, also affects their output. Criteria are given for designing tendon transfer reconstructions from architectural data and moment arm data to best replicate the biomechanical function of the replaced muscle. To have the same capacity for imparting movement to objects and exerting force on them, the donor muscle should have the same moment arm/physiologic cross-sectional area product, the same fiber length/moment arm ratio, and the same tendon length/muscle fiber length ratio as the replaced muscle.

Arm↗