Rule of 13 S's
In a Sensible patient, I will transfer a
- Strong, Sacrificeable, Synergistic tendon with Sufficient excursion
- Straight through a Scarless, Stable bed, Subcutaneously
- across a Supple, Sensate joint
- to achieve a Single function by Securing distally
Patient
- Sensible
Tendon
- Strong (will lose 1 grade of power)
- Sacrifice able
- Synergistic
- Sufficient excursion
Surgery
- Straight
- Subcutaneous
- Straight pull
- Secure distally
- Single function
Joint
- Supple
- Sensate
- Scarless
Definition
Tendon transfer
- tendon of a functioning muscle is mobilised, detached or divided
- reinserted into a bony part or into another tendon
- to supplement or substitute for the action of the recipient tendon
Tenodesis
- the detachment of a tendon & its attachment across a joint
Tendon Graft
- when proximal & distal ends of a tendon are transected
- interposed into another tendon pathology
Indications 3R's
1. Replacement for lost function
- nerve injury
- neurological disease
2. Replacement of ruptured or avulsed tendons
- RA
- EPL in wrist fracture
3. Restoration of balance to a deformed limb
- Cerebral palsty
- stroke