Additional Information
Book Details
Abstract
This issue of Hand Clinics will include articles on tendon transfers in the upper limb such as: Principles of Tendon Transfers, Biomechanics of tendon transfers, Restoration of Shoulder Function, Restoration of Elbow Flexion, Radial Nerve Tendon Transfers, High Median Nerve Tendon Transfers, Low Median Nerve Transfers (Opponensplasty), Ulnar Nerve Tendon Tendon Transfers for Grasp (Intrinsics), and many more!
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Tendon Transfers in theUpper Limb | i | ||
| Copyright | ii | ||
| Contributors | iii | ||
| CONSULTING EDITOR | iii | ||
| EDITOR | iii | ||
| AUTHORS | iii | ||
| Contents | vii | ||
| Preface: An Update on Upper Extremity Tendon Transfers | vii | ||
| Principles of Tendon Transfer | vii | ||
| Biomechanics of Tendon Transfers | vii | ||
| Restoration of Shoulder Function | vii | ||
| Restoration of Elbow Flexion | vii | ||
| Radial Nerve Tendon Transfers | viii | ||
| High Median Nerve Injuries | viii | ||
| Low Median Nerve Transfers (Opponensplasty) | viii | ||
| A Comprehensive Guide on Restoring Grasp Using Tendon Transfer Procedures for Ulnar Nerve Palsy | viii | ||
| Ulnar Nerve Tendon Transfers for Pinch | viii | ||
| Tendon Transfers for Combined Peripheral Nerve Injuries | ix | ||
| Tendon Transfers for Tetraplegia | ix | ||
| Free Flap Functional Muscle Transfers | ix | ||
| Tendon Transfers in the Rheumatoid Hand for Reconstruction | ix | ||
| Tendon Transfers for the Hypoplastic Thumb | x | ||
| Cerebral Palsy Tendon Transfers: Flexor Carpi Ulnaris to Extensor Carpi Radialis Brevis and Extensor Pollicis Longus Rerout ... | x | ||
| HAND CLINICS | xi | ||
| FORTHCOMING ISSUES | xi | ||
| November 2016 | xi | ||
| February 2017 | xi | ||
| May 2017 | xi | ||
| RECENT ISSUES | xi | ||
| May 2016 | xi | ||
| February 2016 | xi | ||
| November 2015 | xi | ||
| Preface:\rAn Update on Upper Extremity Tendon Transfers | xiii | ||
| Principles of Tendon Transfer | 283 | ||
| Key points | 283 | ||
| INTRODUCTION | 283 | ||
| GENERAL PRINCIPLES OF TENDON TRANSFER | 284 | ||
| Preoperative Assessment | 284 | ||
| Tissue Equilibrium | 284 | ||
| Mobile, Intercalary Joints | 284 | ||
| Donor Muscle Properties | 285 | ||
| Adequate strength | 285 | ||
| Excursion | 286 | ||
| Expendable Donor | 286 | ||
| One Tendon, One Function | 287 | ||
| Straight Line of Pull | 287 | ||
| Synergism | 287 | ||
| Surgical Technique | 287 | ||
| Rehabilitation | 288 | ||
| REFERENCES | 288 | ||
| Biomechanics of Tendon Transfers | 291 | ||
| Key points | 291 | ||
| INTRODUCTION | 291 | ||
| BIOMECHANICS FUNDAMENTALS | 291 | ||
| Balance and Synergy | 291 | ||
| Muscle Mechanics | 292 | ||
| Tension | 292 | ||
| Excursion | 294 | ||
| Planning | 294 | ||
| MUSCLE CHANGES FOLLOWING TRANSFER | 294 | ||
| Tension Capacity | 296 | ||
| Excursion | 296 | ||
| Tensioning | 298 | ||
| BIOMECHANICAL CHALLENGES | 299 | ||
| One Muscle Controlling Multiple Joints in Parallel | 299 | ||
| One Muscle Controlling Multiple Joints in Series | 299 | ||
| COAPTATION TECHNIQUES | 300 | ||
| SUMMARY | 301 | ||
| REFERENCES | 301 | ||
| Restoration of Shoulder Function | 303 | ||
| Key points | 303 | ||
| INTRODUCTION | 303 | ||
| Preoperative Planning | 305 | ||
| SURGICAL TECHNIQUE | 305 | ||
| Preparation and Patient Positioning | 305 | ||
| Surgical Approach and Procedure | 305 | ||
| Immediate Postoperative Care | 307 | ||
| REHABILITATION AND RECOVERY | 307 | ||
| CLINICAL RESULTS IN THE LITERATURE | 308 | ||
| SUMMARY | 309 | ||
| REFERENCES | 309 | ||
| Restoration of Elbow Flexion | 311 | ||
| Key points | 311 | ||
| INTRODUCTION | 311 | ||
| TRANSFER OPTIONS | 312 | ||
| Pectoralis Major Transfers | 312 | ||
| Introduction | 312 | ||
| Anatomy | 312 | ||
| Indications | 312 | ||
| Contraindications | 312 | ||
| Review of pectoralis transfer options | 312 | ||
| Tendon transfer | 312 | ||
| Unipolar transfer | 312 | ||
| Bipolar transfer | 312 | ||
| Results | 312 | ||
| Steindler Flexorplasty | 313 | ||
| Introduction | 313 | ||
| Anatomy | 313 | ||
| Indications | 313 | ||
| Contraindications | 313 | ||
| Surgical technique evolution | 314 | ||
| Surgical technique | 314 | ||
| Results | 315 | ||
| Latissimus Transfer | 315 | ||
| Indications | 316 | ||
| Contraindications | 316 | ||
| Surgical technique | 316 | ||
| Results | 317 | ||
| Triceps to Biceps | 317 | ||
| Indications | 317 | ||
| Contraindications | 317 | ||
| Surgical technique | 318 | ||
| Triceps to biceps transfer | 318 | ||
| Isolated long head of triceps to biceps transfer | 318 | ||
| Results | 319 | ||
| SUMMARY | 320 | ||
| REFERENCES | 320 | ||
| Radial Nerve Tendon Transfers | 323 | ||
| Key points | 323 | ||
| INTRODUCTION | 323 | ||
| Nature of the Problem | 323 | ||
| Effect on prehension | 324 | ||
| Relevant anatomy and patient assessment | 324 | ||
| SURGICAL TECHNIQUE | 325 | ||
| Preoperative Planning | 325 | ||
| How good is the patient’s wrist motion? | 326 | ||
| How important is flexor carpi ulnaris function to the patient? | 326 | ||
| Does the patient have a palmaris longus? | 326 | ||
| How important is independent thumb extension or abduction to the patient? | 326 | ||
| Making the choice of tendon transfers | 326 | ||
| Surgical Approach | 326 | ||
| SURGICAL PROCEDURE | 328 | ||
| Step One: Dissection of the Donor Tendons | 328 | ||
| Step Two: Preparation of the Recipient Tendons | 328 | ||
| Step Three: Routing the Donor Tendons to the Recipient Tendons | 328 | ||
| Ensure that the transfers are not compressing the cutaneous nerves | 328 | ||
| Paths that the donor tendons may take | 330 | ||
| Step Four: Weaving the Donor Tendon to the Recipient Tendon | 330 | ||
| Location of weaves | 330 | ||
| Type of weaves | 330 | ||
| Step Five: Tensioning the Transfer | 330 | ||
| The Blix curve and optimal muscle tension | 330 | ||
| Order of tensioning | 330 | ||
| Wrist transfer first | 331 | ||
| Wrist transfer last | 332 | ||
| Immediate Postoperative Care | 332 | ||
| Rehabilitation and Recovery | 332 | ||
| Rehabilitation program | 332 | ||
| Scar management | 334 | ||
| Clinical Results and Literature Review | 334 | ||
| Case series and outcomes | 334 | ||
| Complications | 334 | ||
| Donor deficit | 334 | ||
| SUMMARY | 334 | ||
| ACKNOWLEDGMENTS | 337 | ||
| REFERENCES | 337 | ||
| High Median Nerve Injuries | 339 | ||
| Key points | 339 | ||
| INTRODUCTION | 339 | ||
| NATURE OF THE PROBLEM | 339 | ||
| ANATOMY | 339 | ||
| SURGICAL TECHNIQUE | 340 | ||
| Preoperative Planning | 340 | ||
| Preparation and Patient Positioning | 342 | ||
| SURGICAL APPROACH | 342 | ||
| SURGICAL PROCEDURE | 343 | ||
| IMMEDIATE POSTOPERATIVE CARE | 346 | ||
| CLINICAL RESULTS | 346 | ||
| SUMMARY | 347 | ||
| REFERENCES | 347 | ||
| Low Median Nerve Transfers (Opponensplasty) | 349 | ||
| Key points | 349 | ||
| DEFINING OPPOSITION | 349 | ||
| ANATOMY AND BIOMECHANICS | 350 | ||
| ETIOLOGY | 351 | ||
| PHYSICAL EXAMINATION | 352 | ||
| SURGICAL PROCEDURES | 352 | ||
| Extensor Indicis Proprius | 352 | ||
| Flexor Digitorum Superficialis | 354 | ||
| Palmaris Longus (Camitz) | 355 | ||
| Abductor Digiti Minimi | 357 | ||
| Others | 357 | ||
| SUMMARY | 358 | ||
| REFERENCES | 358 | ||
| A Comprehensive Guide on Restoring Grasp Using Tendon Transfer Procedures for Ulnar Nerve Palsy | 361 | ||
| Key points | 361 | ||
| INTRODUCTION | 361 | ||
| Biomechanics of Grasp | 361 | ||
| Pathophysiology of Deficit | 362 | ||
| SURGICAL TECHNIQUE | 363 | ||
| Simple Claw Hand Reconstructions | 363 | ||
| Metacarpophalangeal Capsulodesis | 363 | ||
| Flexor Digitorum Superficialis Lasso | 363 | ||
| Complex Claw Hand Reconstructions | 364 | ||
| Stiles-Bunnell Flexor Digitorum Superficialis Transfer | 365 | ||
| Wrist Extensor-to-Intrinsic Transfer | 365 | ||
| Flexor Digitorum Profundus Side-to-Side Transfer for High Ulnar Nerve | 366 | ||
| REHABILITATION AND RECOVERY | 367 | ||
| CLINICAL RESULTS IN THE LITERATURE | 367 | ||
| SUMMARY | 367 | ||
| ACKNOWLEDGMENTS | 367 | ||
| REFERENCES | 367 | ||
| Ulnar Nerve Tendon Transfers for Pinch | 369 | ||
| Key points | 369 | ||
| INTRODUCTION | 369 | ||
| Anatomy | 369 | ||
| Etiology of Ulnar Nerve Neuropathy | 370 | ||
| Pathoanatomy | 370 | ||
| Treatment | 371 | ||
| SURGICAL TECHNIQUES | 371 | ||
| Restoration of Thumb Adduction | 371 | ||
| SURGICAL TECHNIQUE | 372 | ||
| Extensor Carpi Radialis Brevis to Adductor Pollicis Muscle Tendon Transfer | 372 | ||
| Flexor Digitorum Superficialis III or IV to Adductor Pollicis Muscle Tendon Transfer | 373 | ||
| Restoration of Index Finger Abduction | 373 | ||
| SURGICAL TECHNIQUE | 374 | ||
| Abductor Pollicis Longus to First Dorsal Interosseous Muscle Tendon Transfer | 374 | ||
| Thumb Metacarpal Phalangeal and Interphalangeal Joint Stabilization | 374 | ||
| SURGICAL TECHNIQUE | 375 | ||
| Split Flexor Pollicis Longus to Extensor Pollicis Longus Transfer | 375 | ||
| SUMMARY | 375 | ||
| REFERENCES | 375 | ||
| Tendon Transfers for Combined Peripheral Nerve Injuries | 377 | ||
| Key points | 377 | ||
| INTRODUCTION | 377 | ||
| LOW MEDIAN-ULNAR NERVE PALSY | 379 | ||
| Key Pinch | 379 | ||
| Thumb Opposition | 380 | ||
| Clawing and Synchronized Flexion | 380 | ||
| HIGH MEDIAN-ULNAR NERVE PALSY | 381 | ||
| Thumb Function | 382 | ||
| Simple Grip and Clawing | 382 | ||
| HIGH ULNAR-RADIAL NERVE PALSY | 383 | ||
| Wrist Extension | 383 | ||
| Thumb and Finger Extension | 383 | ||
| Thumb Adduction | 384 | ||
| Finger Flexion | 384 | ||
| HIGH MEDIAN-RADIAL NERVE PALSY | 384 | ||
| Thumb Opposition | 385 | ||
| Thumb and Finger Extension | 385 | ||
| Thumb and Finger Flexion | 386 | ||
| REHABILITATION AND RECOVERY | 386 | ||
| CLINICAL RESULTS IN THE LITERATURE | 386 | ||
| SUMMARY | 386 | ||
| ACKNOWLEDGMENTS | 386 | ||
| REFERENCES | 386 | ||
| Tendon Transfers for Tetraplegia | 389 | ||
| Key points | 389 | ||
| CERVICAL SPINE INJURY AND CLASSIFICATION | 389 | ||
| PATIENT EVALUATION | 390 | ||
| TREATMENT PRINCIPLES | 391 | ||
| SURGICAL MANAGEMENT | 391 | ||
| ELBOW EXTENSION RECONSTRUCTION | 391 | ||
| HAND RECONSTRUCTION | 392 | ||
| HAND INTRINSIC BALANCING | 394 | ||
| LONG-TERM OUTCOMES | 394 | ||
| SUMMARY | 395 | ||
| REFERENCES | 395 | ||
| Free Flap Functional Muscle Transfers | 397 | ||
| Key points | 397 | ||
| INTRODUCTION | 397 | ||
| PATIENT SELECTION | 397 | ||
| HIERARCHY OF FUNCTIONAL RESTORATION | 398 | ||
| RECIPIENT SITE | 398 | ||
| DONOR MOTOR NERVES | 398 | ||
| DONOR MUSCLE | 399 | ||
| SURGICAL TECHNIQUE FOR GRACILIS MUSCLE HARVEST | 400 | ||
| SURGICAL TECHNIQUE FOR FREE FUNCTIONAL MUSCLE TRANSFER FOR ELBOW FLEXION | 400 | ||
| SURGICAL TECHNIQUE FOR FREE FUNCTIONAL MUSCLE TRANSFER FOR DIGIT FLEXION | 402 | ||
| REPORTED OUTCOMES | 403 | ||
| SUMMARY | 403 | ||
| REFERENCES | 403 | ||
| Tendon Transfers in the Rheumatoid Hand for Reconstruction | 407 | ||
| Key points | 407 | ||
| INTRODUCTION | 407 | ||
| DIAGNOSIS | 408 | ||
| TENDON GRAFTING VERSUS TENDON TRANSFER | 408 | ||
| EXTENSOR TENDON RUPTURES | 409 | ||
| Extensor Pollicis Longus Ruptures | 409 | ||
| PROCEDURE: EXTENSOR INDICIS PROPRIUS TO EXTENSOR POLLICIS LONGUS TENDON TRANSFER | 410 | ||
| Preoperative Planning and Patient Positioning | 410 | ||
| Postoperative Management | 411 | ||
| Isolated Tendon Ruptures | 411 | ||
| PROCEDURE: END-TO-SIDE TENDON TRANSFER | 411 | ||
| Multiple Tendon Ruptures | 412 | ||
| PROCEDURE: MIDDLE AND RING FLEXOR DIGITORUM SUPERFICIALIS TO INDEX THROUGH SMALL EXTENSOR DIGITORUM COMMUNIS TENDON TRANSFER | 413 | ||
| FLEXOR TENDONS | 414 | ||
| SUMMARY | 415 | ||
| REFERENCES | 415 | ||
| Tendon Transfers for the Hypoplastic Thumb | 417 | ||
| Key points | 417 | ||
| BACKGROUND | 417 | ||
| SURGICAL TECHNIQUES | 418 | ||
| Huber Opposition Transfer | 418 | ||
| Flexor Digitorum Superficialis Opposition Transfer | 419 | ||
| General Technical Considerations | 420 | ||
| OUTCOMES | 420 | ||
| REFERENCES | 421 | ||
| Cerebral Palsy Tendon Transfers | 423 | ||
| Key points | 423 | ||
| INTRODUCTION: NATURE OF THE PROBLEM | 423 | ||
| PREOPERATIVE PLANNING—FLEXOR CARPI ULNARIS TO EXTENSOR CARPI RADIALIS BREVIS TENDON TRANSFER | 424 | ||
| Patient Selection | 424 | ||
| Type of Cerebral Palsy | 424 | ||
| Age | 424 | ||
| Cognition and Motivation | 424 | ||
| Preoperative Function (Strength, Voluntary Control, Phasic Contraction) | 425 | ||
| Sensibility | 425 | ||
| PREOPERATIVE PLANNING—EXTENSOR POLLICIS LONGUS REROUTING AND THENAR RELEASE | 425 | ||
| Patient Selection | 425 | ||
| Age | 425 | ||
| SURGICAL TECHNIQUE—FLEXOR CARPI ULNARIS TO EXTENSOR CARPI RADIALIS BREVIS TENDON TRANSFER | 426 | ||
| Preparation and Patient Positioning | 426 | ||
| Surgical Approach | 426 | ||
| Surgical Procedure | 426 | ||
| Immediate Postoperative Care | 427 | ||
| REHABILITATION AND RECOVERY | 427 | ||
| SURGICAL TECHNIQUE—EXTENSOR POLLICIS LONGUS RE-REROUTING AND ABDUCTOR POLLICUS LONGUS RELEASE | 427 | ||
| Surgical Approach | 427 | ||
| Surgical Procedure | 427 | ||
| REHABILITATION AND RECOVERY—EXTENSOR POLLICIS LONGUS REROUTING AND THENAR RELEASE | 428 | ||
| CLINICAL RESULTS | 428 | ||
| Flexor Carpi Ulnaris to Extensor Carpi Radialis Brevis Transfer | 428 | ||
| Extensor Pollicis Longus Rerouting and Thenar Release | 429 | ||
| SUMMARY | 429 | ||
| REFERENCES | 429 | ||
| Index | 431 |