Tendon Transfer: Surgical procedure by which a tendon is incised at its insertion and placed at an anatomical site distant from the original insertion. The tendon remains attached at the point of origin and takes over the function of a muscle inactivated by trauma or disease.Tendons: Fibrous bands or cords of CONNECTIVE TISSUE at the ends of SKELETAL MUSCLE FIBERS that serve to attach the MUSCLES to bones and other structures.Tendon Injuries: Injuries to the fibrous cords of connective tissue which attach muscles to bones or other structures.Achilles Tendon: A fibrous cord that connects the muscles in the back of the calf to the HEEL BONE.Tenotomy: Surgical division of a tendon for relief of a deformity that is caused by congenital or acquired shortening of a muscle (Stedman, 27th ed). Tenotomy is performed in order to lengthen a muscle that has developed improperly, or become shortened and is resistant to stretching.Foot Injuries: General or unspecified injuries involving the foot.Brachial Plexus Neuropathies: Diseases of the cervical (and first thoracic) roots, nerve trunks, cords, and peripheral nerve components of the BRACHIAL PLEXUS. Clinical manifestations include regional pain, PARESTHESIA; MUSCLE WEAKNESS, and decreased sensation (HYPESTHESIA) in the upper extremity. These disorders may be associated with trauma (including BIRTH INJURIES); THORACIC OUTLET SYNDROME; NEOPLASMS; NEURITIS; RADIOTHERAPY; and other conditions. (From Adams et al., Principles of Neurology, 6th ed, pp1351-2)Clubfoot: A deformed foot in which the foot is plantarflexed, inverted and adducted.Paralysis, Obstetric: Paralysis of an infant resulting from injury received at birth. (From Dorland, 27th ed)Suture Anchors: Implants used in arthroscopic surgery and other orthopedic procedures to attach soft tissue to bone. One end of a suture is tied to soft tissue and the other end to the implant. The anchors are made of a variety of materials including titanium, stainless steel, or absorbable polymers.Carpus, Animal: The region corresponding to the human WRIST in non-human ANIMALS.Carpal Joints: The articulations between the various CARPAL BONES. This does not include the WRIST JOINT which consists of the articulations between the RADIUS; ULNA; and proximal CARPAL BONES.Median Neuropathy: Disease involving the median nerve, from its origin at the BRACHIAL PLEXUS to its termination in the hand. Clinical features include weakness of wrist and finger flexion, forearm pronation, thenar abduction, and loss of sensation over the lateral palm, first three fingers, and radial half of the ring finger. Common sites of injury include the elbow, where the nerve passes through the two heads of the pronator teres muscle (pronator syndrome) and in the carpal tunnel (CARPAL TUNNEL SYNDROME).Rotator Cuff: The musculotendinous sheath formed by the supraspinatus, infraspinatus, subscapularis, and teres minor muscles. These help stabilize the head of the HUMERUS in the glenoid fossa and allow for rotation of the SHOULDER JOINT about its longitudinal axis.Equinus Deformity: Plantar declination of the foot.Rupture: Forcible or traumatic tear or break of an organ or other soft part of the body.Thumb: The first digit on the radial side of the hand which in humans lies opposite the other four.Range of Motion, Articular: The distance and direction to which a bone joint can be extended. Range of motion is a function of the condition of the joints, muscles, and connective tissues involved. Joint flexibility can be improved through appropriate MUSCLE STRETCHING EXERCISES.Peroneal Neuropathies: Disease involving the common PERONEAL NERVE or its branches, the deep and superficial peroneal nerves. Lesions of the deep peroneal nerve are associated with PARALYSIS of dorsiflexion of the ankle and toes and loss of sensation from the web space between the first and second toe. Lesions of the superficial peroneal nerve result in weakness or paralysis of the peroneal muscles (which evert the foot) and loss of sensation over the dorsal and lateral surface of the leg. Traumatic injury to the common peroneal nerve near the head of the FIBULA is a relatively common cause of this condition. (From Joynt, Clinical Neurology, 1995, Ch51, p31)Casts, Surgical: Dressings made of fiberglass, plastic, or bandage impregnated with plaster of paris used for immobilization of various parts of the body in cases of fractures, dislocations, and infected wounds. In comparison with plaster casts, casts made of fiberglass or plastic are lightweight, radiolucent, able to withstand moisture, and less rigid.Paralysis: A general term most often used to describe severe or complete loss of muscle strength due to motor system disease from the level of the cerebral cortex to the muscle fiber. This term may also occasionally refer to a loss of sensory function. (From Adams et al., Principles of Neurology, 6th ed, p45)Shoulder Joint: The articulation between the head of the HUMERUS and the glenoid cavity of the SCAPULA.Ankle Joint: The joint that is formed by the inferior articular and malleolar articular surfaces of the TIBIA; the malleolar articular surface of the FIBULA; and the medial malleolar, lateral malleolar, and superior surfaces of the TALUS.Brachial Plexus: The large network of nerve fibers which distributes the innervation of the upper extremity. The brachial plexus extends from the neck into the axilla. In humans, the nerves of the plexus usually originate from the lower cervical and the first thoracic spinal cord segments (C5-C8 and T1), but variations are not uncommon.Patellar Ligament: A band of fibrous tissue that attaches the apex of the PATELLA to the lower part of the tubercle of the TIBIA. The ligament is actually the caudal continuation of the common tendon of the QUADRICEPS FEMORIS. The patella is embedded in that tendon. As such, the patellar ligament can be thought of as connecting the quadriceps femoris tendon to the tibia, and therefore it is sometimes called the patellar tendon.Biomechanical Phenomena: The properties, processes, and behavior of biological systems under the action of mechanical forces.Tendinopathy: Clinical syndrome describing overuse tendon injuries characterized by a combination of PAIN, diffuse or localized swelling, and impaired performance. Distinguishing tendinosis from tendinitis is clinically difficult and can be made only after histopathological examination.Recovery of Function: A partial or complete return to the normal or proper physiologic activity of an organ or part following disease or trauma.Hand: The distal part of the arm beyond the wrist in humans and primates, that includes the palm, fingers, and thumb.Surgical Flaps: Tongues of skin and subcutaneous tissue, sometimes including muscle, cut away from the underlying parts but often still attached at one end. They retain their own microvasculature which is also transferred to the new site. They are often used in plastic surgery for filling a defect in a neighboring region.Gene Transfer Techniques: The introduction of functional (usually cloned) GENES into cells. A variety of techniques and naturally occurring processes are used for the gene transfer such as cell hybridization, LIPOSOMES or microcell-mediated gene transfer, ELECTROPORATION, chromosome-mediated gene transfer, TRANSFECTION, and GENETIC TRANSDUCTION. Gene transfer may result in genetically transformed cells and individual organisms.Muscle, Skeletal: A subtype of striated muscle, attached by TENDONS to the SKELETON. Skeletal muscles are innervated and their movement can be consciously controlled. They are also called voluntary muscles.Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.Embryo Transfer: The transfer of mammalian embryos from an in vivo or in vitro environment to a suitable host to improve pregnancy or gestational outcome in human or animal. In human fertility treatment programs, preimplantation embryos ranging from the 4-cell stage to the blastocyst stage are transferred to the uterine cavity between 3-5 days after FERTILIZATION IN VITRO.Gene Transfer, Horizontal: The naturally occurring transmission of genetic information between organisms, related or unrelated, circumventing parent-to-offspring transmission. Horizontal gene transfer may occur via a variety of naturally occurring processes such as GENETIC CONJUGATION; GENETIC TRANSDUCTION; and TRANSFECTION. It may result in a change of the recipient organism's genetic composition (TRANSFORMATION, GENETIC).Foot Deformities: Alterations or deviations from normal shape or size which result in a disfigurement of the foot.Acromion: The lateral extension of the spine of the SCAPULA and the highest point of the SHOULDER.Orthopedics: A surgical specialty which utilizes medical, surgical, and physical methods to treat and correct deformities, diseases, and injuries to the skeletal system, its articulations, and associated structures.Reward: An object or a situation that can serve to reinforce a response, to satisfy a motive, or to afford pleasure.Posterior Tibial Tendon Dysfunction: A condition characterized by a broad range of progressive disorders ranging from TENOSYNOVITIS to tendon rupture with or without hindfoot collapse to a fixed, rigid, FLATFOOT deformity. Pathologic changes can involve associated tendons, ligaments, joint structures of the ANKLE, hindfoot, and midfoot. Posterior tibial tendon dysfunction is the most common cause of acquired flatfoot deformity in adults.Meningomyelocele: Congenital, or rarely acquired, herniation of meningeal and spinal cord tissue through a bony defect in the vertebral column. The majority of these defects occur in the lumbosacral region. Clinical features include PARAPLEGIA, loss of sensation in the lower body, and incontinence. This condition may be associated with the ARNOLD-CHIARI MALFORMATION and HYDROCEPHALUS. (From Joynt, Clinical Neurology, 1992, Ch55, pp35-6)Flatfoot: A condition in which one or more of the arches of the foot have flattened out.Foot Deformities, Acquired: Distortion or disfigurement of the foot, or a part of the foot, acquired through disease or injury after birth.Friedreich Ataxia: An autosomal recessive disease, usually of childhood onset, characterized pathologically by degeneration of the spinocerebellar tracts, posterior columns, and to a lesser extent the corticospinal tracts. Clinical manifestations include GAIT ATAXIA, pes cavus, speech impairment, lateral curvature of spine, rhythmic head tremor, kyphoscoliosis, congestive heart failure (secondary to a cardiomyopathy), and lower extremity weakness. Most forms of this condition are associated with a mutation in a gene on chromosome 9, at band q13, which codes for the mitochondrial protein frataxin. (From Adams et al., Principles of Neurology, 6th ed, p1081; N Engl J Med 1996 Oct 17;335(16):1169-75) The severity of Friedreich ataxia associated with expansion of GAA repeats in the first intron of the frataxin gene correlates with the number of trinucleotide repeats. (From Durr et al, N Engl J Med 1996 Oct 17;335(16):1169-75)Anterior Cruciate Ligament: A strong ligament of the knee that originates from the posteromedial portion of the lateral condyle of the femur, passes anteriorly and inferiorly between the condyles, and attaches to the depression in front of the intercondylar eminence of the tibia.Anterior Cruciate Ligament Reconstruction: Rebuilding of the ANTERIOR CRUCIATE LIGAMENT to restore functional stability of the knee. AUTOGRAFTING or ALLOGRAFTING of tissues is often used.Knee Injuries: Injuries to the knee or the knee joint.Transplantation, Autologous: Transplantation of an individual's own tissue from one site to another site.Lateral Ligament, Ankle: LATERAL LIGAMENTS of the ANKLE JOINT. It includes inferior tibiofibular ligaments.Sesamoid Bones: Nodular bones which lie within a tendon and slide over another bony surface. The PATELLA (kneecap) is a sesamoid bone.Arthrodesis: The surgical fixation of a joint by a procedure designed to accomplish fusion of the joint surfaces by promoting the proliferation of bone cells. (Dorland, 28th ed)Subtalar Joint: Formed by the articulation of the talus with the calcaneus.Talus: The second largest of the TARSAL BONES. It articulates with the TIBIA and FIBULA to form the ANKLE JOINT.

Effects of aggressive early rehabilitation on the outcome of anterior cruciate ligament reconstruction with multi-strand semitendinosus tendon. (1/175)

To evaluate the effects of aggressive early rehabilitation on the clinical outcome of anterior cruciate ligament reconstruction using semitendinosus (and gracilis) tendon, 103 of 110 consecutive patients who underwent ACL reconstruction using multistrand semitendinosus tendon (ST) or the central one-third of patellar tendon with bony attachments (BTB) were analyzed prospectively. Subjectively, the Lysholm score was not different among the groups. The Lachman test indicated a trend of less negative grade in the ST men's group than that in the BTB men's group. On the patellofemoral grinding test, only women patients of both groups showed pain, with less positive crepitation in the ST group than in the BTB group. KT measurements at manual maximum showed more patients with more than 5 mm differences in the ST group than in the BTB group. The results of this study suggest that aggressive early rehabilitation after the ACL reconstruction using the semitendinosus (and gracilis) tendon has more risk of residual laxity than with the BTB.  (+info)

Function after correction of a clawed great toe by a modified Robert Jones transfer. (2/175)

We carried out a cross-sectional study in 51 patients (81 feet) with a clawed hallux in association with a cavus foot after a modified Robert Jones tendon transfer. The mean follow-up was 42 months (9 to 88). In all feet, concomitant procedures had been undertaken, such as extension osteotomy of the first metatarsal and transfer of the tendon of the peroneus longus to peroneus brevis, to correct the underlying foot deformity. All patients were evaluated clinically and radiologically. The overall rate of patient satisfaction was 86%. The deformity of the hallux was corrected in 80 feet. Catching of the big toe when walking barefoot, transfer lesions and metatarsalgia, hallux flexus, hallux limitus and asymptomatic nonunion of the interphalangeal joint were the most frequent complications. Hallux limitus was more likely when elevation of the first ray occurred (p = 0.012). Additional transfer of the tendon of peroneus longus to peroneus brevis was a significant risk factor for elevation of the first metatarsal (p < 0.0001). The deforming force of extensor hallucis longus is effectively eliminated by the Jones transfer, but the mechanics of the first metatarsophalangeal joint are altered. The muscle balance and stability of the entire first ray should be taken into consideration in the management of clawed hallux.  (+info)

Restoration of elbow flexion by modified Steindler flexorplasty. (3/175)

A modified Steindler flexorplasty was used to restore elbow flexion in 8 patients with post-traumatic flail elbow. In 5 patients there was associated loss of wrist and finger extension, which was treated by tendon transfer and in 2 patients an associated flail shoulder was treated by arthrodesis. The results were not compromised in patients whose flexor tendons had been transferred for wrist and finger extension. All patients had a stable and mobile elbow with marked improvement of upper limb function. Modified Steindler flexorplasty is a simple, effective and reliable procedure for the restoration of elbow flexion.  (+info)

The Ilizarov method in the management of relapsed club feet. (4/175)

We present the results of the management of 17 relapsed club feet in 12 children using the Ilizarov method with gradual distraction and realignment of the joint. Review at a mean of three years after surgery showed maintenance of correction with excellent or good results in 13 feet. Five mobile feet which had been treated by a split transfer of the tibialis anterior tendon two weeks after removal of the frame had an excellent result.  (+info)

Posterior psoas transfer and hip instability in lumbar myelomeningocele. (5/175)

Seventy-two posterior psoas transfer operations performed in forty-four children with lumbar myelomeningocele were reviewed one to eight years after operation in an attempt to assess its value. Muscle charting, an objective recording of the child's walking ability, and radiographic examination of the hips were done. Hip stability was improved: 49 per cent were stable at the time of psoas transfer and 94 per cent at review. Functional results depend mainly on the level of neurological activity present: 57 per cent of the children had an acceptable functional result. Usually, posterior psoas transfer should be done as soon after the age of nine months as the child's condition will allow. Over the age of two years it should be restricted to children with activity in the third and fourth segments of the lumbar cord.  (+info)

Selective release of the flexor origin with transfer of flexor carpi ulnaris in cerebral palsy. (6/175)

Transfer of flexor carpi ulnaris combined with selective release of the flexor pronator origin was undertaken in 35 patients with hemiplegic cerebral palsy for a pronation flexion deformity of the forearm, hand and wrist. The patients were divided into four groups depending on the severity of the deformity, the surgical procedure recommended, potential hand function and prognosis. The procedure reduces the power of wrist and finger flexion by release of the flexor pronator origin, and reinforces the strength of extension and supination of the wrist by transfer of flexor carpi ulnaris. After a mean follow-up of four years the appearance of the hand and forearm improved in all patients. None lost movement and all gained improved mobility of the forearm, wrist and hand. There was no overcorrection.  (+info)

Tendon transfers to improve grasp in patients with cervical spinal cord injury. (7/175)

Patients with cervical spinal cord injury can gain useful hand function from a good rehabilitation programme and non-operative hand care. Effective prehension can usually be achieved by proper positioning, exercises, and splinting but when grasp is poor, tendon transfers are very effective in furthering the goal of independence. These patients have been reviewed extensively and classified into groups according to remaining neurological function. Group I patients have weak elbow flexion and weak shoulder function or less. No tendon transfers were done. Group II patients have shoulder control, elbow flexion and weak wrist extensors. Some of these patients can be improved by transferring the brachioradialis to the radial wrist extensor. Group III patients have the above and good to normal brachioradialis and two radial wrist extensors. Transferring the brachioradialis to restore opposition and the extensor carpi radialis longus to the flexor digitorum profundi provides strong and effective prehension. Group IV patients have the above plus pronator teres and flexor carpi radialis which can be used for transfer. Opposition and finger flexion can be restored by a variety of transfers. In groups III and IV tendon transfers were done only when automatic grasp was poor or absent. If finger grasp was good and thumb function ineffective only opponens transfers were done in order to achieve key pinch. Group V patients have all muscles functioning but with varying degrees of intrinsic weakness. Opponens transfer is useful for these patients. Indications and contraindications to surgery are given. All the patients have improved function and strength following their tendon transfers. No patient has regretted having had surgery.  (+info)

Long-term results of tibialis posterior tendon transfer for drop-foot. (8/175)

Twelve patients with drop-foot secondary to sciatic or common peroneal nerve palsy treated with transfer of the tibialis posterior tendon were followed-up for a mean of 90 (24-300) months. In 10 patients the results were 'excellent' or 'good'. In 11 patients grade 4 or 5 power of dorsiflexion was achieved, although the torque, as measured with a Cybex II dynamometer, and generated by the transferred tendon, was only about 30% of the normal side. Seven patients were able to dorsiflex their foot to the neutral position and beyond. The results appeared to be better in men under 30 years of age with common peroneal palsies. A painful flatfoot acquired in adulthood does not appear to be a significant long-term complication despite the loss of a functioning tibialis posterior tendon.  (+info)

  • Gonçalves S, Caetano R, Corte-Real N. Salvage Flexor Hallucis Longus Transfer for a Failed Achilles Repair: Endoscopic Technique. (springer.com)
  • 1). Wait throughout the entire rehabilitation period before requesting a second tendon transfer surgery unless the defect is manifest from the beginning. (itags.org)
  • 2). Consult with your surgeon about the feasibility of undergoing another tendon transfer surgery, weighing the risks against the benefits. (itags.org)
  • Doctors often will have varying opinions on the feasibility of any particular operation, so having multiple consultations can increase your likelihood of finding someone that is willing to redo your tendon transfer surgery. (itags.org)
  • Yasuda K, Tsujino J, Ohkoshi Y, Tanabe Y, Kaneda K. Graft site morbidity with autogenous semitendinosus and gracilis tendons. (springer.com)
  • Clinical outcome of reverse total shoulder arthroplasty combined with latissimus dorsi transfer for the treatment of chronic combined pseudoparesis of elevation and external rotation of the shoulder. (semanticscholar.org)
  • Our preferred method the patient sitting up and follow - up were excellent in patient, good in more than the lower trapezius latissimus dorsi transfer in human lumbar spine, ed , st louis, , mosby. (sacredwaters.net)
  • Is there any reason that I cannot bill 28285 three times with T6, T7, T8 and 27691, 27692, and 27692 again for each FDL to EDL tendon transfer done with the hammertoe correction? (aapc.com)
  • Obtain as much information as possible about the benefits and risk of multiple tendon transfers on the same hand before making the decision to operate again. (itags.org)
  • 3). Seek a second or third option if your primary surgeon is unwilling or unable to perform another tendon transfer operation. (itags.org)
  • Recovery from lower trapezius tendon transfer is a slow process and you must ensure you follow the prescribed rehabilitation protocol for strengthening muscles and improving range of motion. (curtisbushmd.com)
  • This direct suture between the donor muscle and the recipient tendons directly couples the movement of all the joints actuated by the recipient tendons, leading to reduced hand function in physical interaction tasks such as grasping, a key aspect for activities of daily living. (oregonstate.edu)
  • The purpose of this study is, therefore, to pursue a method of estimating available donor tendon lengths based on easily measured anatomical surface landmarks. (readbyqxmd.com)
  • The most important technical consideration in the final outcome of these procedures are the tension and position with which the donor tendon is attached to the recipient tendon. (elsevier.com)
  • Silver and colleagues calculated the strength of the posterior tibial tendon to be 6.4, the anterior tibial tendon to be 5.6, the peroneus longus 5.5, the flexor hallucis longus 3.6, the peroneus brevis 2.6 and the flexor digitorum longus tendon to be 1.8, with muscle strength relative to the proportional cross-sectional area. (podiatrytoday.com)
  • Anterior submuscular transfer affords good functional outcomes without addressing the nonunion of the lateral condyle of humerus. (aaos.org)
  • At the palm, the flexor digitorum superficialis (FDS) tendon lies volar to the profundus tendon. (medscape.com)
  • P. Kiran Sasi, Swagath Mahapatra, Samuel C. Raj Pallapati, and Binu P. Thomas, "Acute Traumatic Musculotendinous Avulsion of the Flexor Pollicis Longus Tendon Treated with Primary Flexor Digitorum Superficialis Transfer: A Novel Technique of Management," Case Reports in Orthopedics , vol. 2016, Article ID 2106203, 4 pages, 2016. (hindawi.com)
  • This is often performed when the peroneus longus muscle is overactive relative to the brevis tendon, causing the base of the great toe to be driven into the ground with each step. (footeducation.com)
  • With pathology of the posterior tibial tendon, its antagonist, the peroneus brevis tendon, acts as a deforming force in the development of hindfoot valgus and forefoot abduction. (podiatrytoday.com)
  • Similar moment arms were measured when the attachment site on the peroneus brevis tendon was located either proximally or distally, suggesting that this choice does not appear to significantly affect the mechanical outcome. (elsevier.com)