The Basics and Science of Tendon Transfers

Bluman, Eric M.; Dowd, Thomas

doi:10.1016/j.fcl.2011.06.002

Cited by 17 publications

(4 citation statements)

References 37 publications

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“…Omer 11 reported that full active dorsiflexion is rarely restored by TP tendon transfer alone. Because a transferred muscle usually loses one grade of strength, 1 full recovery of dorsiflexion strength may be difficult despite a long period of rehabilitation. Yeap et al 20 reported that the torque generated by the transferred TP tendon for foot drop was about 30% compared to normal contralateral side, although 11 of 12 patients achieved clinically grade 4 or 5 muscle power of dorsiflexion.…”

Section: Discussionmentioning

confidence: 99%

Functional Outcomes Following Anterior Transfer of the Tibialis Posterior Tendon for Foot Drop Secondary to Peroneal Nerve Palsy

et al. 2017

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Section: Discussionmentioning

confidence: 99%

Functional Outcomes Following Anterior Transfer of the Tibialis Posterior Tendon for Foot Drop Secondary to Peroneal Nerve Palsy

et al. 2017

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“…Preference is given to donor muscles with similar muscle power, tendon excursion, and phasic activity during the gait cycle (with muscles active during similar periods of the gait cycle referred to as “in-phase” for transfer). 18 The TA muscle does not have a complementary muscle which matches all of these criteria. EDL and EHL are the other muscles of the anterior compartment which are in-phase.…”

Section: Tendon Transfermentioning

confidence: 99%

Evaluation and Management of Adult Footdrop

Haupt

Chan

Michalski

et al. 2022

J Am Acad Orthop Surg

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Footdrop is a common musculoskeletal condition defined by weakness in ankle joint dorsiflexion. Although the etiology varies, footdrop is characterized by specific clinical and gait abnormalities used by the patient to overcome the loss of active ankle dorsiflexion. The condition is often associated with deformity because soft-tissue structures may become contracted if not addressed. Patients may require the use of special braces or need surgical treatment to address the notable level of physical dysfunction. Surgical treatment involving deformity correction to recreate a plantigrade foot along with tendon transfers has been used with notable success to restore a near-normal gait. However, limitations and postoperative dorsiflexion weakness have prompted investigation in nerve transfer as a possible alternative surgical treatment.

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“…1 The FHL transfer technique is a well-established method for augmenting degenerative Achilles tendinopathy, tendon rupture, and revision surgery. 3 Several methods for securing tendon to bone have been introduced 4 ; however, modern operative repair techniques for FHL transfer use interference screws. 6,16 Incorporation of an interference screw was introduced by Cohn et al 5 Several technique variations have been described, including an endoscopic approach 12 and integration of a cortical button.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical Analysis of Single Interference Screw vs Interference Screw With Cortical Button for Flexor Hallucis Longus Transfer

Neary

McClish

Khoury

et al. 2021

Foot & Ankle Orthopaedics

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Background: Flexor hallucis longus tendon transfer (FHL) with a cortical button tension slide is an innovative addition that has not been measured against traditional methods. Methods: 12 pairs (n=24) of fresh-frozen cadaveric tibia-to-toe samples were used and randomized to receive one of the operative FHL techniques. Specimens underwent bone density analysis. Biomechanical loading was applied between 20 and 60 N at 1 Hz for 100 cycles. Post–cyclic load to failure occurred at 1.25 mm/s. Cyclic displacement, structural stiffness, and ultimate load were derived from load-displacement curves. Student t tests evaluated significant effects between both FHL techniques. Linear regression analysis assessed interactions between bone density and strength of FHL technique. Results: Average tendon diameter was 5.44±0.46 mm. Average bone density was 1.06±0.08 g/cm2. Addition of a cortical button to FHL transfer did not significantly affect cyclic displacement (0.78±0.52 mm vs 0.87±0.80 mm) or structural stiffness (162.11±43.34 N/mm vs 167.57±49.19 N/mm). Cortical button addition to FHL transfer resulted in significantly increased ultimate load (343.72±68.93 N) compared with interference screw alone (255.62±77.17 N) ( P = .0002). Linear regression analyses did not reveal any significant interactions between bone density and FHL tendon transfer technique. Conclusion: Enhanced strength can be achieved with FHL tendon transfer to calcaneus using an interference screw and cortical button tension slide technique as compared to an interference screw alone. Cortical buttons in the setting of FHL tendon transfer to the calcaneus offers an additional level of support. Clinical Relevance: Operative cases presenting with poor bone quality due to osteoporosis or osteopenia could benefit from cortical button fixation during FHL transfer. Clinical studies are needed to determine if the increased construct stability conferred from the additional use of a flip button results in fewer FHL transfer failures or better clinical outcomes. Level of Evidence: Level V, Controlled Laboratory Study.

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The Basics and Science of Tendon Transfers

Cited by 17 publications

References 37 publications

Functional Outcomes Following Anterior Transfer of the Tibialis Posterior Tendon for Foot Drop Secondary to Peroneal Nerve Palsy

Functional Outcomes Following Anterior Transfer of the Tibialis Posterior Tendon for Foot Drop Secondary to Peroneal Nerve Palsy

Evaluation and Management of Adult Footdrop

Biomechanical Analysis of Single Interference Screw vs Interference Screw With Cortical Button for Flexor Hallucis Longus Transfer

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