Movahedi Tendon Transfer in Common Peroneal Nerve Palsy

The article's abstract is not available.

Influence of the flexor digitorum superficialis tendon transfer on grip strength

The flexor digitorum superficialis tendon of the ring finger can be transferred to the thumb flexor. We followed ten patients after such a transfer for 5–128 months and measured grip strength and force transmission of the fingers and individual phalanges while the patients gripped 10-cm or 20-cm diameter cylinders. The grip strength of the middle, ring and little fingers was reduced when gripping the 10-cm cylinder, with a significantly larger decrease in the ring finger. With the 20-cm cylinder, grip forces of all fingers were almost identical, with slightly lower force of the ring finger and slightly higher forces in the index and small fingers. We conclude that after transfer of flexor digitorum superficialis tendon from a ring finger, grip strength of the ring finger is reduced. Finger forces are more hampered while gripping objects with smaller circumferences than large ones.

Rotator cuff irreparability or failure of repair (re-tear): technical note on middle trapezius tendon transfer for reproduction of supraspinatus function

Purpose Based on its close anatomic features and nearly-collinear force vector to those of supraspinatus muscle, the current article describes a technique of middle trapezius tendon transfer for reproduction of supraspinatus function in the context of rotator cuff irreparability/re-tear management. Methods While seating the patient in beach-chair position, arthroscopic gleno-humeral examination and sub-acromial decompression are initially performed. Hamstring tendons are harvested and fashioned as flattened quadruple sheet. Through McKenzie approach, infraspinatus and subscapularis tendons are repaired. Then, medial half of middle trapezius insertion tendon is harvested from most medial 5-6 cm of the scapular spine. Through McKenzie approach, hamstring sheet is retrieved via a sub-trapezius/sub-acromial corridor from the scapular wound. Hamstring sheet is re-attached to cuff footprint by double row/suture bridge repair configuration. While retracting the scapula and placing gleno-humeral joint in 45O-abduction/45O-external rotation, hamstring sheet is re-attached to released middle trapezius tendon by non-absorbable sutures. Finally, tendon reconstruct is dynamically-tested in different positions of range of motion. Results Transfer of medial portion of middle trapezius insertion tendon (lengthened by interposition hamstring tendon sheet) to cuff footprint was technically feasible. Dynamic testing showed smooth sub-acromial gliding motion of the tendon reconstruct. Conclusion For reproduction of supraspinatus function, hamstring tendon augmented-middle trapezius tendon transfer to cuff footprint heralds a number of technical and biomechanical advantages; thus offering a potential effective modality of cuff irreparability/re-tear management in relatively young patients of high functional demands. However, current description should be investigated in further biomechanical and clinical studies to validate its long-term outcomes.

Reconstruction of the Lateral Collateral Ligament Using a Suture Tape Anchor for Iatrogenic Hallux Varus

Iatrogenic hallux varus is a difficult complication of hallux valgus surgery. Although tendon transfer combined with bony correction is performed for hallux varus, tendon transfer has several disadvantages, such as the complicated nature of the procedure and the donor site morbidity. We describe the case of a 70-year-old woman with iatrogenic hallux varus treated by lateral collateral ligament (LCL) reconstruction using a suture tape anchor with bony correction. Tarsometatarsal joint arthrodesis was performed to correct the narrow intermetatarsal angle (IMA), and the varus deformity of the great toe at the metatarsophalangeal joint was corrected by anatomical reconstruction of the LCL using the suture tape anchor. One year postoperatively, the Japanese Society for Surgery of the Foot Hallux Metatarsophalangeal-Interphalangeal Scale had improved from 37 to 90 points. Radiography confirmed that the hallux valgus angle had been corrected from -24° to 4° and the IMA from 0° to 8°. Reconstruction of the LCL using suture tape anchor is an easy procedure for iatrogenic hallux varus which can achieve good stabilization.