Can Tho Transfer Technique: Extensor Hallucis Longus to Tibialis Anterior Tenodesis for Footdrop

2021 ◽  
Vol 111 (4) ◽  
Author(s):  
Ezequiel Palmanovich ◽  
Wing Ip ◽  
Em Huynh ◽  
Jeffrey Spanko ◽  
Meir Nyska ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Mechanical Strength ◽  
Success Rate ◽  
Tibialis Anterior ◽  
Tendon Transfer ◽  
New Approach ◽  
Extensor Hallucis Longus ◽  
Four Corners

Background Footdrop, or the inability to actively dorsiflex the foot, may result from numerous pathologic conditions, including poliomyelitis and cerebral palsy. Although the gait of patients with footdrop can be improved by performing an extensor hallucis longus (EHL) to tibialis anterior (TA) tendon transfer, the success rate of this procedure is relatively low. Methods Seven paralytic patients with footdrop were surgically treated using a new buttonhole-type technique that involves passing a loop of the EHL through a TA split using umbilical tape and suturing at the four corners of the EHL attaching to the TA while the foot is dorsiflexed. Results Eight years after surgery, all three patients who were available for follow-up displayed active dorsiflexion, improved mobility, and a palpable TA-EHL tenodesis, with no cockup deformity. Conclusions This new approach, which we term Can Tho transfer, improves the mechanical strength of TA-EHL tenodesis.

Torn Earlobe: A New Approach to Management with a Review of 68 Cases

1994 ◽  
Vol 103 (11) ◽  
pp. 879-884 ◽  
Author(s):  
David Reiter ◽  
Eugene L. Alford
Keyword(s):  
Success Rate ◽  
Historical Development ◽  
Statistical Data ◽  
Objective Analysis ◽  
New Approach ◽  
Or Management ◽  
New Methods ◽  
Historical Factors

The torn earlobe is a common problem, yet no objective analysis of causation or management is found in the literature. We present a series of 68 patients with statistical data on earlobe characteristics and cleft-related historical factors. We describe three new methods of repair: two for full clefts and one for partial clefting (ie, elongation of the piercing site without penetration of the inferior rim). We report follow-up from 4 to 10 years, with a 91% success rate for lobe appearance and a 1.2% recurrence of clefting. We offer guidelines for repair and repiercing based on lobe thickness and shape. We make recommendations for earring use based on lobe characteristics and historical development of the defect.

scholarly journals Suture Button Technique for Tibialis Anterior Tendon Transfer for the Treatment of Residual Clubfoot

2020 ◽  
Vol 5 (2) ◽  
pp. 247301142092359
Author(s):  
Chanseok Rhee ◽  
Bernard Burgesson ◽  
Ben Orlik ◽  
Karl Logan
Keyword(s):  
Tibialis Anterior ◽  
Tendon Transfer ◽  
Case Series ◽  
Idiopathic Clubfoot ◽  
Safe Procedure ◽  
Level Of Evidence ◽  
Tibialis Anterior Tendon ◽  
Suture Button ◽  
Operative Notes

Background: The Ponseti method has revolutionized the treatment of idiopathic clubfoot, but recurrence remains problematic. Dynamic supination is a common cause of recurrence, and the standard treatment is tibialis anterior tendon transfer using an external button. Although safe and effective, the placement of the button on the sole creates a pressure point, which can lead to skin ulceration. In our institution, a suture button has been used for the tibialis anterior tendon transfer and we report our results here. Methods: Two senior authors’ case logs were retrospectively reviewed to identify 23 patients (34 feet) for tibialis anterior tendon transfer using a suture button. Complications and additional operative procedures were assessed by reviewing operative notes, follow-up visit clinic notes, and radiographs. The mean age of the patients was 6 years 2 months (SD 40 months) and the average follow-up duration was 67.1 weeks (SD 72 weeks). Results: There were 5 complications (14.7%). Recurrence occurred bilaterally in 1 patient (5.9%) but did not require reoperation. Other complications included a cast-related pressure sore (2.9%) and an infection (2.9%) requiring irrigation with debridement along with hardware removal. Conclusions: Tibialis anterior tendon transfer using a suture button was a safe procedure with theoretical advantage of providing stronger fixation and reducing the risk of skin pressure necrosis compared to the standard external button technique. We believe a suture button could allow earlier rehabilitation and may afford stronger ankle eversion. Prospective studies are required to compare the differences in functional outcomes between the procedures. Level of Evidence: Level IV, case series, therapeutic study.

Long-term follow-up after tibialis anterior tendon shortening in combination with Achilles tendon lengthening in spastic equinus in cerebral palsy

2017 ◽  
Vol 58 ◽  
pp. 457-462 ◽  
Author(s):  
Michèle Kläusler ◽  
Bernhard Maria Speth ◽  
Reinald Brunner ◽  
Oren Tirosh ◽  
Carlo Camathias ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Achilles Tendon ◽  
Tibialis Anterior ◽  
Tibialis Anterior Tendon ◽  
Tendon Lengthening ◽  
Long Term Follow Up ◽  
Achilles Tendon Lengthening

Flexor Carpi Ulnaris Tendon Transfers in Cerebral Palsy

1998 ◽  
Vol 23 (3) ◽  
pp. 340-343 ◽  
Author(s):  
T. M. WOLF ◽  
C. M. CLINKSCALES ◽  
C. HAMLIN
Keyword(s):  
Cerebral Palsy ◽  
Retrospective Study ◽  
Tendon Transfer ◽  
Standard Procedure ◽  
Extensor Digitorum ◽  
Outcome Predictors ◽  
Tendon Transfers ◽  
Flexor Carpi Ulnaris ◽  
Extensor Carpi Radialis

Flexor carpi ulnaris tendon transfer to either the extensor carpi radialis longus or extensor carpi radialis brevis has become a standard procedure to improve function in patients with cerebral palsy. In this retrospective study of the procedure, we have compared preoperative and postoperative wrist position, analysed potential outcome predictors and assessed function by objective and subjective measures. Sixteen children, with flexor carpi ulnaris transfer to extensor carpi radialis longus or brevis or extensor digitorum, were tested at an average follow-up of 4 years (range, 1–9). General resting position improved and the centre of the arc of motion averaged 6° pronation and 9° extension. Subjectively, 14 of 16 parents felt there was an improvement in function, 16 of 16 felt that cosmesis was improved, 14 of 16 would recommend the procedure to others, and 15 of 16 were satisfied overall.

Extensor Hallucis Longus Coaptation to Tibialis Anterior: A Treatment for Paralytic Drop Foot

Foot & Ankle ◽  
1993 ◽  
Vol 14 (6) ◽  
pp. 343-346 ◽  
Author(s):  
Rajan Asirvatham ◽  
Hugh G. Watts ◽  
Hamish Gillies
Keyword(s):  
Physical Therapy ◽  
Tibialis Anterior ◽  
Drop Foot ◽  
Navicular Bone ◽  
Great Toe ◽  
The Poor ◽  
Extensor Hallucis Longus ◽  
Toe Deformity ◽  
Do So

Between June 1982 and April 1983, a procedure to coapt the extensor hallucis longus (EHL) to the tibialis anterior was performed in eight post-polio patients to correct drop foot and to enable the EHL to be a more efficient dorsiflexor of ankle. Although at early follow-up, every patient was able to actively dorsiflex the ankle against gravity, at final review, (mean follow-up 7.8 years), only two patients could still do so. Three patients developed a cock-up toe deformity or dorsiflexion deformity of great toe. We have attributed the poor final results to stretching of the coaptation. Use of splints or orthosis for a longer period postoperatively and a more carefully designed physical therapy may have yielded better results. Alternatively, if the EHL is anchored to navicular bone better results may be obtained.

The Modified Robert Jones Tendon Transfer in Cases of Pes Cavus and Clawed Hallux

1994 ◽  
Vol 15 (2) ◽  
pp. 68-71 ◽  
Author(s):  
Martin C. Tynan ◽  
L. Ch.M. Klenerman
Keyword(s):  
Spinal Cord ◽  
Cerebral Palsy ◽  
Retrospective Study ◽  
Tendon Transfer ◽  
Metatarsal Head ◽  
Pes Cavus ◽  
Main Indication ◽  
First Metatarsal ◽  
Spinal Cord Tethering

This is a retrospective study of the modified Robert Jones tendon transfer in 24 patients and 28 feet. The main indication for the procedure was to correct symptoms related to clawing of the hallux in seven patients, relieve pressure under the head of the first metatarsal in 13 patients, and treat for both symptoms in three patients. One patient had diffuse ache in the arch. Fifteen patients had idiopathic cavus feet, of whom five had associated spina bifida occulta. The remainder had a variety of different etiologies including cerebral palsy, head injury, brain abscess, and spinal cord tethering. Postoperative follow-up ranged from 7 months to 33 years with an average of 5 years and 6 months. The modified Robert Jones tendon transfer was shown to be effective in relieving symptoms related to clawing of the hallux in 90% of patients but was not reliable in curing pain under the first metatarsal head, with success in only 43% of patients. In three patients, pain under the metatarsal head was relieved initially but recurred by 18 months. Complications were frequent. Six patients developed pain under the tip of the hallux postoperatively

Hand function in children with hemiplegic cerebral palsy: prospective follow-up and functional outcome in adolescence, Erratum

2003 ◽  
Vol 45 (03) ◽  
Author(s):  
Ermellina Fedrizzi ◽  
Emanuela Pagliano ◽  
Elena Andreucci ◽  
Giovanna Oleari
Keyword(s):  
Cerebral Palsy ◽  
Functional Outcome ◽  
Hand Function ◽  
Hemiplegic Cerebral Palsy
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