Flexor Carpi Radialis to Palmaris Longus Tendon Transfer for Spontaneous Rupture of the Flexor Carpi Radialis Tendon—A Review of an Uncommon Finding and Surgical Technique for Operative Correction

2016 ◽  
Vol 21 (03) ◽  
pp. 417-421 ◽  
Author(s):  
Jonathan Winkworth Shearin ◽  
Brian Walters ◽  
S. Steven Yang
Keyword(s):  
Surgical Technique ◽  
Range Of Motion ◽  
Spontaneous Rupture ◽  
Inflammatory Diseases ◽  
Operative Therapy ◽  
Longus Tendon ◽  
Flexor Carpi Radialis ◽  
Palmaris Longus ◽  
Surgical Options ◽  
Palmaris Longus Tendon

Spontaneous ruptures of the flexor carpi radialis tendon (FCR) are rare and associated with systemic inflammatory diseases, localized tendinopathy related to scaphotrapezial-trapezoidal arthritis, or chronic immunosuppression from corticosteroids. While most cases do not require operative intervention, some patients develop weakness, impaired range of motion, and persistent pain. Previously reported surgical options include synovectomy, tendon stump resection, and osteophyte removal. We describe a surgical technique for patients with persistent symptomatology following FCR rupture in which the FCR is transposed end-to-side to the palmaris longus tendon. Three cases using this technique are presented with follow-up of 4–9 months that were collected at Lenox Hill Hospital. All three patients did well regarding specific outcome measures: grip strength, range of motion, and functional activity. FCR transfer to palmaris is an alternative to other surgical options for the spontaneous rupture of the FCR tendon in patients who remain symptomatic despite a course of non-operative therapy.

A Novel Surgical Technique for Chronic Mallet Finger Injury: A Case Report

2017 ◽  
Vol 22 (01) ◽  
pp. 114-117 ◽  
Author(s):  
Taku Suzuki ◽  
Naoto Inaba ◽  
Kazuki Sato
Keyword(s):  
Case Report ◽  
Surgical Technique ◽  
Range Of Motion ◽  
Anatomical Reconstruction ◽  
Mallet Finger ◽  
Longus Tendon ◽  
Palmaris Longus ◽  
Finger Injury ◽  
Palmaris Longus Tendon ◽  
Little Finger

A 39-year-old man injured his left little finger and was diagnosed with chronic tendon mallet with -50° of extension and 80° of flexion at the DIP joint. We performed an anatomical reconstruction of the terminal tendon and both lateral bands with divided palmaris longus tendon grafting. Postoperative range of motion at the DIP joint improved to -5° of extension with no flexion loss. We demonstrated a novel surgical technique for chronic tendon mallet injury that might represent a useful choice for the treatment of chronic mallet finger injury.

Anatomical Acromioclavicular Ligament Reconstruction

2005 ◽  
Vol 33 (11) ◽  
pp. 1723-1728 ◽  
Author(s):  
Paul W. Grutter ◽  
Steve A. Petersen
Keyword(s):  
Ligament Reconstruction ◽  
Acromioclavicular Joint ◽  
Tendon Graft ◽  
Longus Tendon ◽  
Flexor Carpi Radialis ◽  
Palmaris Longus ◽  
Fresh Frozen ◽  
Palmaris Longus Tendon ◽  
Mechanism Of Failure ◽  
Surgical Treatments

Background Current surgical treatments for acromioclavicular separations do not re-create the anatomy of the acromioclavicular joint. Hypothesis Anatomical acromioclavicular reconstruction re-creates the strength of the native acromioclavicular joint and is stronger than a modified Weaver-Dunn repair. Study Design Controlled laboratory study. Methods The native acromioclavicular joint in 6 fresh-frozen cadaveric upper extremities was stressed to failure under uniaxial tension in the coronal plane. A modified Weaver-Dunn procedure, anatomical acromioclavicular reconstruction using a palmaris longus graft, and anatomical acromioclavicular reconstruction using a flexor carpi radialis graft were then performed sequentially. Each repair was stressed to failure. Load-displacement curves and mechanism of failure were recorded for each. Results Loads at failure for the native acromioclavicular joint complex, modified Weaver-Dunn procedure, anatomical acromioclavicular reconstruction using a palmaris longus tendon graft, and anatomical acromioclavicular reconstruction using a flexor carpi radialis tendon graft were 815 N, 483 N, 326 N, and 774 N, respectively. The strength of the native acromioclavicular joint complex was significantly different from the modified Weaver-Dunn repair (P <. 001) and the anatomical acromioclavicular reconstruction using a palmaris longus tendon graft (P <. 001) but not from the anatomical acromioclavicular reconstruction using a flexor carpi radialis tendon graft (P =. 607). Conclusion The strength of the described anatomical acromioclavicular reconstruction is limited by the tendon graft used. Anatomical acromioclavicular reconstruction with a flexor carpi radialis tendon graft re-creates the tensile strength of the native acromioclavicular joint complex and is superior to a modified Weaver-Dunn repair.

Lunotriquetral Ligament Reconstruction Utilizing a Palmaris Longus Autograft

2017 ◽  
Vol 22 (04) ◽  
pp. 544-547 ◽  
Author(s):  
Carl M. Harper ◽  
Matthew L. Iorio
Keyword(s):  
Range Of Motion ◽  
Grip Strength ◽  
Ligament Reconstruction ◽  
Longus Tendon ◽  
Palmaris Longus ◽  
Lunotriquetral Ligament ◽  
Palmaris Longus Tendon ◽  
Tendon Autograft

Injury to the lunotriquetral ligament can result in midcarpal instability, with resultant alterations in normal wrist kinematics and subsequent arthrosis. We performed a previously undescribed technique of lunotriquetral ligament reconstruction in two patients utilizing a palmaris longus tendon autograft. Average age at presentation was 24 years old with a mean follow up of 10 months. Average range of motion was 62.5° of flexion and 57.5° of extension. Total arc of motion was 83% of the contralateral uninvolved extremity. Average grip strength was 31 kg which was 91% of the contralateral extremity. Average Quick Disability of Arm, Shoulder and Hand score was 12.5 and Modern Activity Subjective Survey of 2007 was 1.5. No complications were noted.

Harvest of Palmaris Longus Tendon: Technique

1993 ◽  
Vol 18 (5) ◽  
pp. 583-584 ◽  
Author(s):  
W. R. SAEED ◽  
S. P. KAY
Keyword(s):  
Longus Tendon ◽  
Palmaris Longus ◽  
Minimal Scarring ◽  
Palmaris Longus Tendon ◽  
Stab Incision

We present a modification of Bunnell’s technique for harvest of the palmaris longus tendon. Using a 0.5 cm distal incision and a proximal stab incision the tendon is harvested with minimal scarring and, in our experience of over 30 cases, no morbidity.

scholarly journals Iatrogenic Injury to the Median Nerve During Palmaris Longus Harvest

Hand ◽  
2016 ◽  
Vol 12 (1) ◽  
pp. NP6-NP9 ◽  
Author(s):  
Joshua Choo ◽  
Bradon J. Wilhelmi ◽  
Morton L. Kasdan
Keyword(s):  
Median Nerve ◽  
Tendon Graft ◽  
Iatrogenic Injury ◽  
True Incidence ◽  
Longus Tendon ◽  
Palmaris Longus ◽  
Palmaris Longus Tendon

Background: A rare and disastrous complication of harvesting a tendon graft is the misidentification of the median nerve for the palmaris longus. Methods: The authors report a referred case in which the median nerve was harvested as a free tendon graft. Results: Few reports of this complication are found in the literature despite the frequency of palmaris longus tendon grafting and the proximity of the palmaris tendon to the median nerve. Given the obvious medicolegal implications, the true incidence of this complication is difficult to assess. Discussion: Safe harvesting of the palmaris longus mandates a thorough understanding of the relevant anatomy, in particular the proper differentiation between nerve and tendon and recognition of when the palmaris longus tendon is absent. Techniques to facilitate proper identification of the palmaris longus are outlined.

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