Distal Biceps Brachii Tendon Transfer for Re-establishing Extrinsic Finger Function: Feasibility Study in Cadavers.

Area of Science:

• Orthopedic surgery
• Biomechanical engineering
• Anatomy

Background:

• Restoring finger flexion and extension is crucial for patients with FDP or EDC dysfunction.
• The biceps brachii tendon is a potential autograft for tendon transfers.

Purpose of the Study:

• To assess the anatomical feasibility of transferring the biceps brachii tendon to the EDC or FDP.
• To quantify the tendon excursion achieved with these transfers.
• To compare the work capacity of the transferred biceps to recipient muscles using PCSA.

Main Methods:

• Cadaveric study using four shoulder-elbow-wrist specimens.
• Distal biceps tendon transfer to EDC in two specimens and to FDP in two specimens.
• Measurement of tendon excursion via passive and active loading; calculation of PCSA.

Main Results:

• Both distal biceps-to-EDC and -to-FDP transfers yielded an average of 24 mm tendon excursion.
• The average PCSA of the biceps specimens was 3.6 cm².
• The biceps PCSA approximated EDC PCSA but was half that of FDP.

Conclusions:

• Distal biceps tendon transfer to EDC or FDP is anatomically feasible, providing significant tendon excursion.
• This transfer offers a viable option for functional restoration in cases of FDP or EDC deficiency.
• The biomechanical properties of the transferred biceps are comparable to EDC but less than FDP.