- Tensioning the Graft:
- as a muscle is tensioned to mid stretch, most of the potential energy generated results from passive tension of elastic recoil;
- note that the tenodesis effect can effectively increase tendon excursion by 2-3 cm;
- Mayer's Rule:
- origin is brought as close as possible to the insertion and the tendon is then sutured w/ no tension;
- the greatest contraction force is exerted when a muscle is at resting length (on Blix curve);
- flexor to extensor transfer:
- it is permissible to error slightly on the side of over-tensioning;
- w/ slight overtensioning, the patient may have difficulty in achieving full flexion, however, there will be no difficulty in achieving full extension;
- in addition, many of these patients will regain full flexion w/ time;
- extensor to flexor transfer:
- take care not to over tension the graft;
- overtensioning will lead to flexion contracture of the digit;
Excursion of prime wrist tendons.
Early Tendon Transfers in Upper Extremity Peripheral Nerve Injury.
WE Burkhalter. COOR No 104, Oct 1974.
Fundamental principles of tendon transfer.
R Curtis.
Ortho Clinics of North America. Vol 5. p 231. 1984.
Relative tension and potential excursion of muscles in the forearm and hand.
PW Brand and RB Beach.
J. Hand Surg. Vol 4. p 281. 1979.
The technique and timing of tendon transfers.
GE Omer.
Orthop Clin North America. Vol 5. 1974. p 243.
Relative tension and potential excursion of muscles in the forearm and hand.
PW Brand et al.
J. Hand Surg. Vol 6. p 209. 1981.
Biomechanics of tendon transfer.
PW Brand.
Orthop. Clinics of North America. Vol 5. 205. 1974.
Biomechanics of tendon transfers.
PW Brand.
Hand Clinics.
Vol 4. 1988. p 137.
Determination of muscle tendon unit properties during tendon transfer.
AA Freehafer et al.
J. Hand Surg. Vol 4. 1979. p 331.
Relative tension and potential excursion of muscles in the forearm and hand.
PW Brand et al.
J. Hand Surg. Vol 6 A. 1981. p 209-219.
