- Discussion:
- most commonly used tendon graft for the hand;
- palmaris longus tendon is extrasynovial and does not have synovial membrane;
- instead of synovial membrane, the tendon has a paratenon which does not
promote gluiding as well as intrasynovial tendons;
- PreOp Planning:
- determine whether
palmaris longus is present w/ active
opposition of thumb against the litter finger;
- attempt to palpate the tendon, as well as, to determine the thickness of the
tendon (if there is indication that the tendon is small, the patient should
be consented for possible graft harvest from other areas of the body);
- Technique:
- make transverse wrist incision;
- spread away the areolar tissue and identify the tendon;
- make a second transverse incision, about 8 cm above the first incision,
and again identify the tendon;
- pull on tendon from both wounds to ensure that the same tendon has been
isolated in both wounds;
- a third transverse incision can be made, even more proximally;
- alternatively, an appropriately sized tendon stripper can be used;
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Boundary Lubrication between the Tendon and the Pulley of the Finger.
S. Uchyama MD, P.C. Amadio MD, J. Ishikawa MD,
JBJS. Vol 79-A, Feb 1997.
p 213-218.
