Podcast
Questions and Answers
What is a key principle to consider when selecting a tendon for transfer?
What is a key principle to consider when selecting a tendon for transfer?
Which grade of power loss is acceptable when transferring a muscle tendon unit?
Which grade of power loss is acceptable when transferring a muscle tendon unit?
What is the recommended course for the transferred tendon to follow after the surgery?
What is the recommended course for the transferred tendon to follow after the surgery?
Which technique involves attaching tendons to bone directly?
Which technique involves attaching tendons to bone directly?
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What is the problem associated with side-to-side lengthening or transfers?
What is the problem associated with side-to-side lengthening or transfers?
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What device is NOT typically used to secure tendons to bone?
What device is NOT typically used to secure tendons to bone?
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What is the primary purpose of a tendon transfer procedure?
What is the primary purpose of a tendon transfer procedure?
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Which of the following is an example of a tendon transfer procedure?
Which of the following is an example of a tendon transfer procedure?
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Which principle of tendon transfers is most important to consider when planning the procedure?
Which principle of tendon transfers is most important to consider when planning the procedure?
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In a tendon transposition procedure, what is the key difference compared to a standard tendon transfer?
In a tendon transposition procedure, what is the key difference compared to a standard tendon transfer?
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What is the primary goal of a muscle-tendon transplantation procedure?
What is the primary goal of a muscle-tendon transplantation procedure?
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Which type of tendon transfer procedure involves the detachment of a tendon at its insertion and relocation to a new attachment site?
Which type of tendon transfer procedure involves the detachment of a tendon at its insertion and relocation to a new attachment site?
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Which of the following is NOT a primary reason for performing a tendon transfer?
Which of the following is NOT a primary reason for performing a tendon transfer?
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In a tendon transfer procedure, which of the following steps is typically performed first?
In a tendon transfer procedure, which of the following steps is typically performed first?
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Which of the following is a potential complication of a tendon transfer procedure?
Which of the following is a potential complication of a tendon transfer procedure?
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In a tendon transposition procedure, what is the primary goal?
In a tendon transposition procedure, what is the primary goal?
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Which of the following tendons is commonly used as a donor graft for tendon transfers in the hand?
Which of the following tendons is commonly used as a donor graft for tendon transfers in the hand?
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In the context of tendon transfers, what does the term 'tendon detachment' refer to?
In the context of tendon transfers, what does the term 'tendon detachment' refer to?
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What is a key principle to consider when determining the ideal tendon for transfer?
What is a key principle to consider when determining the ideal tendon for transfer?
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In the context of tendon transfers, what is the recommended range of movement remaining within the joint where the transferred muscle will act?
In the context of tendon transfers, what is the recommended range of movement remaining within the joint where the transferred muscle will act?
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Which grade of power loss is considered acceptable when transferring a muscle tendon unit?
Which grade of power loss is considered acceptable when transferring a muscle tendon unit?
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What is the primary problem associated with side-to-side lengthening or transfers?
What is the primary problem associated with side-to-side lengthening or transfers?
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Which technique involves attaching tendons to bone directly rather than to another tendon?
Which technique involves attaching tendons to bone directly rather than to another tendon?
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What is the optimal course for the transferred tendon to follow after surgery according to the principles of tendon transfers?
What is the optimal course for the transferred tendon to follow after surgery according to the principles of tendon transfers?
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What is the primary function of a tendon sheath in the context of tendon anatomy?
What is the primary function of a tendon sheath in the context of tendon anatomy?
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What distinguishes a tendon sheath from a paratenon in terms of function?
What distinguishes a tendon sheath from a paratenon in terms of function?
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During which phase of tendon healing does the response to tendon injury involve overlapping stages?
During which phase of tendon healing does the response to tendon injury involve overlapping stages?
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What characterizes the inflammatory phase of tendon healing?
What characterizes the inflammatory phase of tendon healing?
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Which type of tendons are associated with paratenon, nerve, and blood vessels according to the text?
Which type of tendons are associated with paratenon, nerve, and blood vessels according to the text?
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What is the primary distinction between a tendon sheath and mesotenon in terms of structure?
What is the primary distinction between a tendon sheath and mesotenon in terms of structure?
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Which type of tendon repair involves debridement and tubulerization of the tendon ends?
Which type of tendon repair involves debridement and tubulerization of the tendon ends?
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What is the primary purpose of a tendon transfer procedure?
What is the primary purpose of a tendon transfer procedure?
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Which of the following is an example of a tendon transposition procedure?
Which of the following is an example of a tendon transposition procedure?
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Which principle of tendon transfers is most important to consider when planning the procedure?
Which principle of tendon transfers is most important to consider when planning the procedure?
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What is the key difference between a tendon transfer and a tendon transposition procedure?
What is the key difference between a tendon transfer and a tendon transposition procedure?
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What is a key principle of tendon transfer procedures?
What is a key principle of tendon transfer procedures?
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Study Notes
Principles of Tendon Transfers
- Tendon to be transferred ideally should be phasic
- Adequate range of movement within the joint on which the transferred muscle will act should be remaining
- Muscle must have adequate power (at least M4 or M5) and the transfer is recommended even for a weak muscle if it's the deforming force
- After the transfer, the tendon should run in as straight a course as possible with zero tension
Types of Tendon Transfers
- Side-to-side/Tenodesis
- Tendon-to-bone
Securing Tendons to Bone
- Trephine
- Button
- Screw and Washer
- Suture Anchor
- Biotenodesis/Interference Screw
Tendon Healing
Phases of Tendon Healing
- Inflammatory
- Proliferative
- Remodeling (starts 1-2 months after injury, lasts more than a year, and tissue never completely regains pre-injury properties)
Phases of Tendon Repair
- Debridement with Tubulerization
- End-to-end Reconstruction
- Debridement/Tubulerization End-to-end Repair Reconstruction
- Krakow
Tendon Reconstruction Options
- Allograft Reconstruction
Tendon Transfers Purpose
- Detachment of a tendon of a functioning muscle at its insertion and then relocation to a new insertion or attachment
- Rerouting of the course of a normal muscle tendon without detachment to assist other functions
- Muscle-Tendon Transplantation
- Tendon Suspension (tenosuspension)
Tendon Anatomy
- Epitenon (synovial layer) surrounds the tendon
- Paratenon (areolar tissue) continuous with epitenon contains nerve and blood vessels
- Mesotenon is epitenon + paratenon
- Tendon Sheath: tubular structure prevents bowstringing, found in tendons that curve, lined with synovial cells, and allows tendon to glide like a piston in a cylinder
Tendon Histology
- 55-70% water
- Extracellular matrix (ECM) primarily of aligned Type I collagen fibers (65-80% dry weight)
- Elastin, Aggrecan, Decorin, Biglycan, and Fibromodulin
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Description
Test your knowledge on the principles of tendon transfers with this quiz. Questions cover topics such as phasic transfer, range of movement, and muscle power requirements.
