Rheumatoid Arthritis Tendon Transfers - Patrick Lusty 9/1/2001

Background

Principles of Tendon Transfers according to Boyes (Boyes J H: Bunnell's Surgery of the Hand. Edition 5 Philadelphia, J B Lippincott, 1970)

  1. Correction of contracture before transfer
  2. Adequate power, not too weak or strong
  3. Sufficient Amplitude
  4. Straight line of pull
  5. Maintenance of integrity of he muscle , one muscle can not act in two different places

Pattern of tendon rupture in Rheumatoid Arthritis

  1. EPL often isolated, X rays may not show RA changes
  2. Extensor tendon rupture, EDM commonest, subsequently progressing radialward. Due to erosion of the distal ulna through the dorsal capsule (Vaughan-Jackson type)
  3. FPL most common flexor tendon to rupture

Brief MOUNTNEY, J of Hand Surgery 1998
Author Mountney J, Blundell C M, et al
Title Free tendon interposition grafting for the repair of ruptured extensor tendons in the rheumatoid hand
Reference Journal of Hand Surgery 1998; 23B: 5: 662-665
Summary Discusses the use of interposition grafting using PL for ED rupture in rheumatoid arthritis rather than traditional end to side tendon transfer. Gives a biomechanical argument to support interposition grafts as well as a review of patients who had this procedure.
Critique Good Biomechanical argument. 7 rheumatoid hands with 16 extensor tendon repairs, review average 17 months all had interposition grafting, retrospective no data on alternative methods to compare with.



Please log in to view the content of this page.
If you are having problems logging in, please refer to the login help page.


© 2011 Orthoteers.co.uk Website by Regency Medical Marketing 
Biomet supporting orthoteersThe British Orthopedic Association supporting OrthoteersOrthoteers is a non-profit educational resource. Click here for more details
Bone Graft in Distal Radius Fractur...
Carpal Tunnel Syndrome - Wessex OWL...
Classification of Distal Radius fra...
Distal Radius Fractures - Adam Rumi...
Distal Radius Shortening as a resul...
External Fixation for Distal Radius...
External Fixation for Wrist Fractur...
Rheumatoid Arthritis Tendon Transfe...
Rheumatoid Wrist Arthroplasty & Art...
Rheumatoid Wrist Conservative Surge...
Wrist Fracture Classification - An...
Wrist Fusion - Callum Clark 24/7/20...
Wrist Wiring and Fracture Stability...
OWLS Biomet - advanced science for living
Orthoteers Junior Orthoteers Orthopaedic Biomechanics Orthopaedic World Literature Society Educational Resources Image Gallery About Orthoteers Orthoteers Members search
Hide Menu