Tendon transplantation in the upper extremity

Steindler, Arthur

doi:10.1016/s0002-9610(39)90954-2

Cited by 52 publications

(13 citation statements)

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“…Prior to muscle transfers, Steindler described proximal advancement of the medial epicondylar origin of the flexor-pronator mass. 10 Though effective in increasing the elbow flexion moment of wrist flexors, strength and active flexion gains have been inferior to latissimus transfer, and both the elbow and wrist can develop pronation and flexion contractures. 11 Pectoralis major and sternocleidomastoid, while described, are less commonly used due to poor cosmesis and need for fascia lata graft interposition, respectively.…”

Section: Introductionmentioning

confidence: 99%

Bipolar latissimus transfer for restoration of elbow flexion

Chaudhry

Hopyan

2013

Journal of Orthopaedics

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Section: Introductionmentioning

confidence: 99%

Bipolar latissimus transfer for restoration of elbow flexion

Chaudhry

Hopyan

2013

Journal of Orthopaedics

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“…2a shortening of a normally functioning flexor carpi ulnaris muscle in a wrist held in persistent flexion by paralysed or weak extensors. We have recorded a similar inadequacy in length of the transferred flexor carpi ulnaris musculotendinous unit when proximal advancement of the common flexor origin to the humerus (Steindler's flexorplasty 13 ) has already been performed to restore elbow flexion in patients with injury to the upper brachial plexus.…”

Section: Discussionmentioning

confidence: 91%

“…There were no other surgical procedures performed at the same time, but all but one patient had undergone previous surgery as part of the staged reconstructive surgical protocol. These operations included latissimus dorsi and teres major transfer to supraspinatus, proximal advancement of the common flexor origin to the humerus (Steindler flexorplasty) 13 for elbow flexion, total wrist arthrodesis without bone grafting, 14 flexor pronator slide 15 and shoulder fusion (Table I).…”

Section: Methodsmentioning

confidence: 99%

Flexor carpi ulnaris tendon transfer to the split brachioradialis tendon to restore supination in paralytic forearms

Anderson

Thomas

Pallapati

2010

The Journal of Bone and Joint Surgery. British volume

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Inability to actively supinate the forearm makes common activities of daily living and certain vocational activities awkward or impossible to perform. A total of 11 patients with deficient supination of the arm underwent transfer of the tendon of flexor carpi ulnaris to the split tendon of brachioradialis with its bony insertion into the radial styloid left intact. Active supination beyond neutral rotation was a mean of 37.2 degrees (25 degrees to 49.5 degrees ) at a minimum follow-up of three years, representing a significant improvement (95% confidence interval 25 to 50, p < 0.001). Functional evaluation of the hand after this transfer showed excellent and good results in ten patients and fair in one. The split tendon of brachioradialis as an insertion for transfer of the flexor carpi ulnaris appears to provide adequate supination of the forearm without altering the available pronation and avoids the domination of wrist extension sometimes associated with transfers of the flexor carpi ulnaris to the radial extensors of the wrist.

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“…Previously it has been suggested that it may be preferable to place the transferred MTU under excess tension, relying on postoperative relaxation and lengthening to correct any errors. 17 Obviously, this is not possible for every patient, though if its course is through scarred, inflamed, or oedema tissues, then it may be desirable to revise the soft tissue bed using flaps or grafts. 16 Ultimately, the surgeon should aim to neither over-nor undertension the transferred MTU by setting it as close to its optimal length as possible.…”

Section: Tensioningmentioning

confidence: 99%