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At least 199 records · Page 11Linked to original sources
PubMed2000

[Tendon transfer of the extensor carpi radialis longus muscle in tendon rupture of the extensor pollicis muscle].

The most common ruptures of all of the tendons of the hand are those of the extensor pollicis longus tendon (EPL). As to its etiology, the rupture of EPL can spontaneously occur tendosynovitis in rheumatic patients or rarely in result of conservative treatment of distal forearm fractures. During the last 18 months, 4 cases of EPL ruptures following the conservative treatment of distal forearm fractures have been diagnosed in our clinical material. All patients underwent the transfer of extensor carpi radialis longus (ECRL) tendon due to. We present our indications of the technique, and the clinical results. (Fig. 3, Ref. 8.)

Humans↗
PubMed1991

Tendon transfers in patients with cervical spinal cord injury.

Between 1983 and 1988, 32 patients with cervical spinal cord injuries underwent 124 upper limb tendon transfers during 85 procedures. Of the numerous surgical procedures that have been recommended for treatment of this condition, my experience indicates that the most successful are posterior deltoid-to-triceps transfer, restoration of finger flexion, and restoration of thumb opposition. Longitudinal incisions prove to be quite cosmetic.

Activities of Daily Living↗
PubMed1998

Posterior tibial tendon transfer for drop-foot. 20 cases followed for 1-5 years.

From 1991 to 1997 we performed 20 tibialis posterior tendon-transfer operations in 17 patients with drop-foot, in 11 of peripheral neurogenic origin and in 6 because of neuromuscular disease. Postoperatively, all patients could walk without an ankle-foot orthosis. At follow-up after mean 2 (1-5) years, all patients had active dorsiflexion of the foot and toes, with a median active ankle dorsiflexion of 5 degrees (-15-10 degrees). The median active plantar flexion was 40 degrees (10-45 degrees), and the total range of movement was 40 degrees (15-50 degrees). At follow-up, the gait was good in 15 and improved in 2 of the 17 patients.

Adolescent↗
PubMed1993

Tendon transfer to restore extension of the thumb using abductor pollicis longus.

20 patients with rupture or division of extensor pollicis longus (EPL) underwent tendon transfer using abductor pollicis longus (APL). All patients except one were reviewed and examined between 6 and 80 months after surgery. The subjective and objective results were satisfactory and are presented with details of the technique and its advantages and limitations.

Adolescent↗
PubMedDate not supplied

Latissimus dorsi tendon transfer for massive rotator cuff tears: a cadaveric study.

Certain massive defects of the rotator cuff tendinous insertion cannot be repaired primarily to the greater tuberosity. If restoration of strength is an important treatment goal to the patient, then a tendon transfer may be considered. Ten cadaver shoulders were dissected to define the anatomy of the latissimus dorsi tendon (LDT) and its distance relationship to the axillary and radial nerves with the arm in various positions. The axillary nerve lies superior to the LDT insertion, and the radial nerve passes medial and inferior to the LDT insertion. With the arm internally rotated and the shoulder flexed, the distances from the axillary and radial nerves to the LDT insertion were 2.3 cm and 2.8 cm, respectively. With the arm internally rotated and the shoulder abducted, the distances from the axillary and radial nerves to the LDT insertion were 1.8 cm and 2.0 cm, respectively. Understanding specific anatomic relationships is one of the factors contributing to the safety of the LDT transfer procedure with respect to nerve injury.

Adult↗
PubMed1989

Early restoration of pinch grip after ulnar nerve repair and tendon transfer.

Restoration of pinch in ulnar nerve lesions may be achieved within three or four weeks by a one-stage operation combining nerve repair and tendon transfer. We have been using this approach for nerve injuries of the upper limb since 1961, to meet the socio-economic needs of patients who would otherwise need splints and long-term physiotherapy. In our experience, the procedure of choice is transfer of E.I.P. to adductor pollicis and E.P.B. to the first dorsal interosseous. The operative technique and its results in 18 patients followed up for 37-515 days are discussed.

Adult↗
PubMed1985

Median nerve function after tendon transfer for ulnar paralysis.

This is a long term follow-up study of the median nerves of 128 leprosy patients who originally had pure ulnar palsy for which they had tendon transfers to correct claw hand. Of the thirty-one cases in which the carpal tunnel was not used as a pathway for tendon grafts, 16% developed median palsy in the subsequent years. Of the ninety-seven cases in which tendon grafts were passed through the carpal tunnel, 7% developed a transient median nerve palsy and 11% developed permanent median palsy. None of the median nerve palsies developed during the weeks or months of post-operative re-education or observation, but were noted at follow-up visits months or years later. It is concluded that the use of the carpal tunnel did not significantly affect the status of those high-risk median nerves in cases of leprosy.

Follow-Up Studies↗
PubMed1988

Tendon transfers for shoulder paralysis in children.

The treatment of shoulder paralysis in children is discussed and a new classification system is presented. The importance of treating contracture before considering tendon transfers is emphasized, especially for internal rotation contracture where subscapularis release alone results in the return of active external rotation is 47 per cent of patients. Specific transfers for external rotation, internal rotation and abduction are discussed.

Child, Preschool↗
PubMed1998

Tendon transfers in tetraplegic patients: the Cleveland experience.

The author has taken care of patients with spinal cord injury for over 30 years. A major part of these years was spent doing tendon transfers on the patients with tetraplegia. Thirteen were not better, but not worse out of the 285 patients who had an operation. All of the patients have had a period of rehabilitation, waited 1 year following spinal injury, and had a stable neurological examination. The goals of the surgery were wrist extension, elbow extension, thumb pinch, and finger grasp. This was based on the author's classification of the characteristic muscle strengths that are present in the completely paralysed tetraplegic patient. One group of patients had weak or no wrist extension. These patients needed a transfer of the brachioradialis to the extensor carpi radialis brevis. Some of these patients required a posterior deltoid transfer to act as an obstacle to the brachioradialis. The next group of patients had no elbow extension, but had brachioradialis and two radial wrist extensors. They required a posterior deltoid transfer, and an opponens transfer and a transfer to give finger flexion. The next group had elbow extension, brachioradialis, two radial wrist extensors and a pronator teres, and needed an opponens transfer, and a transfer to give finger flexion. The last group of patients had poor or no opposition, and required an opponens transfer.

Adult↗
PubMed2000

[Tendon transfers to restore hand function following peripheral nerve injury in the arm].

Three patients, a woman aged 33 years, a man aged 42 and a woman aged 66, had a loss of hand function. This was due to denervation of a peripheral nerve, in essence the radial, ulnar and median nerves respectively. In the first two cases this was caused by trauma and in the third by compression neuropathy. The problems were loss of wrist and finger extension (a dropping hand) in the first, loss of intrinsic muscle function and thumb adduction in the second and loss of opposition in the third patient. Tendon transfers were performed by diverting a tendon insertion of a still functional muscle to another tendon to correct the disturbed mechanical balance in the affected upper extremity. After initial immobilisation during several weeks intensive rehabilitation was started. All patients had improvement of range of motion and power in the affected wrist and fingers. In this way a better daily function and resumption of work were accomplished.

Adult↗
PubMed1982

Posterior tibial tendon transfer: a review of the literature and analysis of 74 procedures.

At Rancho Los Amigos Hospital on the Children's Orthopedic Service, 43 patients underwent anterior transfer of the posterior tibial tendon through the interosseous membrane between 1969 and 1979. This included 74 procedures for the following diagnoses: Duchenne muscular dystrophy, club-foot, cerebrospastic disease (cerebral palsy and head injury), Charcot-Marie-Tooth disease, scapuloperoneal dystrophy, and peroneal palsy. The purpose of this paper is to present the 54 of these transfers that have a minimum 2 year follow-up were performed with a uniform surgical technique, and had uniform postoperative management. This series is analyzed and compared with a review of the literature in order to set down guidelines for the use of the procedure. The analysis reveals that the patient with Duchenne muscular dystrophy who has decreasing gait function or brace fitting problems is the ideal candidate for the procedure with 26 of 28 satisfactory results. Gait electromyography was critical to the selection of the cerebrospastic patient for the transfer with those patients demonstrating swing-phase function of the posterior tibialis muscle yielding the best results. Finally, posterior tibial tendon transfer is generally not indicated in congenital clubfoot with six unsatisfactory results in 10 procedures, and the procedure should not be done in Charcot-Marie-Tooth disease as part of staged treatment that includes a possible future hindfoot stabilization.

Cerebral Palsy↗
PubMed1994

Simulation of distal tendon transfer of the biceps brachii and the brachialis muscles.

Rupture of the distal tendons of the biceps brachii and the brachialis often consists of a clean avulsion of the end of the tendons from their tuberosities. In most of the reattachment procedures these tendons are reinserted to the same tuberosities. The purpose of this study was to examine the kinetic activity in the upper limb when the insertion locations of the two prime elbow flexors are altered. The right upper limb was modeled as a two-bar linkage moving in the vertical plane of the scapula. Our Hill-type musculo-tendon actuation system was modeled in terms of five muscles moving in three-dimensional space. The prime elbow flexors, i.e. the biceps brachii and the brachialis, were excited maximally, while the other muscles were left passive and were included as such in the analysis. The limb kinetics was studied in four different insertion locations of the biceps brachii and the brachialis. Data on the elbow kinematics, the muscle tensions histories, the muscle length-tension and velocity-tension relationships and the joint constraint forces were produced. The results indicate that when the new insertions of the biceps brachii and the brachialis are located further away from the elbow joint axis, the moments of these muscles about the joint axis increase. However, the shortening velocities of these muscles are increased as well, which results in a reduced tension. In addition, the magnitudes of the compressive force, the tangential forces and the torsional and bending moments are reduced. These results suggest that, whenever surgically possible, reinsertion of ruptured distal tendons of the biceps brachii and the brachialis more distally to the location of their tuberosities should be beneficial.

Acceleration↗
PubMedDate not supplied

Split tibialis posterior tendon transfer and tendo-Achillis lengthening for spastic equinovarus feet.

Twenty-one patients with a minimum follow-up of 2 years who underwent combined split tibialis posterior tendon transfer and tendo-Achilles lengthening for equinovarus foot deformities were evaluated. The results in 15 of 18 ambulatory patients were graded as excellent or good; patients had marked improvement of their equinovarus foot deformity in both stance and swing phases of gait and became brace-free postoperatively. All non-ambulatory patients had a plantigrade foot. The complication rate was low, and patient satisfaction with the procedure was very high. In three patients, however, the procedure failed because of technical errors. We address the causes of failure and methods to avoid these errors. Preoperative computerized gait analysis does not appear to be essential in achieving a good result.

Achilles Tendon↗
PubMed2006

Extremity salvage with a free musculocutaneous latissimus dorsi flap and free tendon transfer after resection of a large congenital fibro sarcoma in a 15-week-old infant. A case report.

A case of complex microsurgical reconstruction of the dorsum of the foot, including tendon transfer following tumor resection, in a 15-week-old male infant is presented. After birth, a 5.5 x 4 cm large tumor was observed on the dorsum of the right foot. Biopsy showed a congenital malignant fibro sarcoma. After initial chemotherapy a radical excision of the tumor at the age of 14 weeks was followed. To cover the defect a musculocutaneous latissimus dorsi flap was taken, the cutaneous part being large enough to cover the defect. Extensor tendons were reconstructed with free tendon transplants. Amputation is usually indicated in these cases. To the best of our knowledge, microsurgical reconstruction in infants at this age with congenital malignant tumors has not yet been reported. The case shows that Plastic surgery can play an important role in pediatric oncology and should routinely be integrated into the multi-modal treatment concepts.

Biopsy↗