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[Tenodesis in hand surgery].

M Revol1, J-M Servant

  • 1Service de chirurgie plastique, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, Paris cedex 10, France. marc@revol.org

Chirurgie De La Main
|December 1, 2009
PubMed
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Tenodesis surgery anchors tendons across joints to restore function, utilizing the natural "tenodesis effect." This technique is crucial for palliative care in cases of muscle paralysis.

Area of Science:

  • Orthopedic Surgery
  • Biomechanics
  • Reconstructive Surgery

Context:

  • Tenodesis involves surgically attaching tendon ends to bone across one or more joints.
  • It leverages the inherent mechanical coupling between tendon and joint motion, known as the 'tenodesis effect'.
  • Classifications include simple, dynamic, crossed dynamic, and direct dynamic tenodesis based on joint involvement and anatomical orientation.

Purpose:

  • To define tenodesis, its classifications, and the underlying biomechanical principle (tenodesis effect).
  • To provide anatomical examples illustrating different tenodesis types.
  • To highlight the primary application of tenodesis techniques in palliative surgical interventions.

Summary:

  • Tenodesis surgery secures tendon ends to bone, bridging joints to combine tendon inextensibility with joint mobility.

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  • The 'tenodesis effect' describes how joint movements influence adjacent tendons, with examples in wrist and finger joints.
  • Key applications are in palliative surgery for paralysis affecting finger intrinsic muscles, thumb extrinsic muscles (EPL, FPL, APL, EPB), and EDC.

    • Impact:

    • Provides a foundational understanding of tenodesis for surgeons and researchers.
    • Clarifies the biomechanics of tendon-joint interactions.
    • Offers insights into reconstructive options for debilitating paralytic conditions affecting the hand and thumb.