Principles

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