Correlation between Passive Stretch and Active Contraction Distance and Characteristics of Musculotendinous Units...

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Musculoskeletal Research

Background:

• Tendon reconstruction outcomes are often unpredictable.
• Selecting the correct muscle-tendon unit is critical for success.
• Wide-awake local anesthesia no tourniquet (WALANT) surgery enables intraoperative patient movement.

Purpose of the Study:

• To investigate active muscle contraction during WALANT surgery for tendon reconstruction.
• To evaluate the utility of observing muscle-tendon characteristics intraoperatively.

Main Methods:

• Evaluated 148 muscle-tendons from 213 WALANT tendon reconstructions.
• Measured active contraction distance and passive stretch distance.
• Analyzed muscle active contraction patterns and time elapsed before reconstruction.

Main Results:

• Active contraction and passive stretch distances positively correlated; flexor muscles showed greater distances than extensors.
• Time to reconstruction did not correlate with contraction or stretch distances.
• Specific patterns observed in flexor digitorum superficialis and extensor indicis proprius muscles.

Conclusions:

• WALANT surgery uniquely allows intraoperative assessment of muscle-tendon active contraction.
• This intraoperative evaluation appears beneficial for tendon transfer procedures.