Free tendon grafts in elder patients, a case report of repair of flexor pollicis longus tendon with a free palmaris longus graft in an 89-year-old woman

Panafieu, E. de; Upex, Peter; Doursounian, Levon; Robert, Nadia

doi:10.1016/j.anplas.2014.09.009

Cited by 4 publications

(2 citation statements)

References 13 publications

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“…7,8 Similarly, it has been described that primary repair of FPL by simple advancement can be achieved for gaps equivalent to or smaller than 1 cm with acceptable outcome, 9 but no study to our knowledge has looked at the upper limit to which the FPL can be advanced. In an effort to prevent undue tension at the repair site, techniques like interpositional tendon graft have been developed for gaps of 5 cm 10 as well as step-cut lengthening for gaps of 2 cm. 11 It has traditionally been left to surgeon discretion regarding the optimal surgical technique for a given length gap without a clear consensus.…”

Section: Discussionmentioning

confidence: 99%

Subcutaneous Transposition of the Flexor Pollicis Longus: Does It Provide Increased Length for Tendon Repair? A Cadaveric Study

Shoap

Strauch

2019

Hand (New York, N,Y.)

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Background: Flexor pollicis longus (FPL) tendon lacerations typically occur via sharp mechanisms such as knife injury. When the injury is chronic, it may be difficult to perform a tension free repair, and tendon lengthening may be required. This article proposes a technique that transposes the proximal tendon stump over the thenar eminence subcutaneously, out of the carpal tunnel, in an attempt to gain additional tendon length by eliminating the sharp turn the FPL takes. Methods: A total of 17 cadaveric hands were used. The FPL tendon was identified and affixed to soft tissue in the distal forearm as well as at the thumb metacarpophalangeal (MP) joint with hypodermic needles. The tendon was then transected at the level of the MP joint of the thumb, removed from the carpal tunnel, and transposed on top of the thenar eminence to reach where it had been transected. The length gained by transposing the tendon was recorded by measuring the overlap of the tendon ends at the MP joint. Results: The mean amount lengthened was 7.6 mm with a standard deviation of 2.4 mm, ranging from as little as 5 mm to as high as 13 mm. Conclusions: To our knowledge, transposition of FPL tendon is a novel technique that has not been reported. Based on our cadaveric study, it can be used to bridge gaps between approximately 5 mm and 10 mm. Clinically, this amount of gap could potentially be more easily managed by simply making the repair tighter than usual as opposed to transposing the tendon.

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Section: Discussionmentioning

confidence: 99%

Subcutaneous Transposition of the Flexor Pollicis Longus: Does It Provide Increased Length for Tendon Repair? A Cadaveric Study

Shoap

Strauch

2019

Hand (New York, N,Y.)

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“…Primary repair of chronic FPL tendon ruptures is difficult due to tendon abrasion and muscle retraction. Surgical treatment options are transfer of the flexor digitorum superficialis (FDS) tendon of the middle or ring finger to the thumb (10), tendon reconstruction with an interposition graft (11,12,13), tendon advancement (14) or fusion of the interphalangeal joint (15,16). Preferred management has not been determined yet as only few reports present the outcome of their surgical treatment in detail (4,6,12,17,18).…”

Section: Introductionmentioning

confidence: 99%

Reconstruction of flexor pollicis longus tendon with palmaris longus interposition graft: results in 14 patients

Peters¹,

Caekebeke²,

Duerinckx³

2022

Acta Orthop Belg

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The flexor pollicis longus tendon is prone to attritive rupture and retraction. Direct repair is often not possible. Interposition grafting is a treatment option to restore tendon continuity, although the surgical technique and postoperative results have not been well defined. We report our experience with this procedure. 14 patients were prospectively followed for a minimum of 10 months after surgery. There was one postoperative failure of the tendon reconstruction. Postoperative strength was comparable to the contralateral side, but thumb range of motion was significantly reduced. In general, patients reported excellent postoperative hand function. This procedure seems a viable treatment option with lower donor site morbidity than tendon transfer surgery.

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Translational Challenges in Soft Tissue Regeneration

Liu

Ernst

Klingelhoefer

et al. 2019

Regenerative Medicine and Plastic Surgery

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Free tendon grafts in elder patients, a case report of repair of flexor pollicis longus tendon with a free palmaris longus graft in an 89-year-old woman

Cited by 4 publications

References 13 publications

Subcutaneous Transposition of the Flexor Pollicis Longus: Does It Provide Increased Length for Tendon Repair? A Cadaveric Study

Subcutaneous Transposition of the Flexor Pollicis Longus: Does It Provide Increased Length for Tendon Repair? A Cadaveric Study

Reconstruction of flexor pollicis longus tendon with palmaris longus interposition graft: results in 14 patients

Translational Challenges in Soft Tissue Regeneration

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