The role of tenodesis in surgery of the upper limb

Abstract

This paper describes the presence of tenodesis effects in normal physiology and explores the uses of operative tenodesis in surgery of the upper limb.

Clinical and Biomechanical Evaluation of an All-Arthroscopic Suprapectoral Biceps Tenodesis

“…In addition to the popeye deformity and pain on exertion, tenotomy has been shown to result in loss of power in elbow flexion and supination of the forearm, as well as weakness with vigorous use of the biceps. 4 , 7 …”

“…In addition to the popeye deformity and pain on exertion, tenotomy has been shown to result in loss of power in elbow flexion and supination of the forearm, as well as weakness with vigorous use of the biceps. 4,7 Biceps tenodesis is a popular alternative to tenotomy and can be performed either open or arthroscopically. Tenodesis is often the favored procedure in younger, thinner, or more active patients.…”

Practical applications of tenodesis in hand surgery

“…The quadriga effect is based on the fact that the FDP of all four fingers shares a common muscle belly, hence following a flexor tendon repair, if the repair is too tight, it will affect the normal flexion of other fingers leading to a loss of the normal synchronous flexion of fingers. [3] The tenodesis procedures in hand surgery can be broadly classified into simple and dynamic tenodesis depending on whether the tendon traverses one or more joints.…”

“…[5] Similarly, the FDS tenodesis procedure is used to correct swan neck deformity; here, a distally based halfslip of FDS tendon is brought through a window in the A2 pulley and sutured to itself to create a check rein against PIPJ hyperextension. [3] Dynamic tenodesis involves the tendon traversing two or more joints leading to synchronous movement of adjacent joints. This translates as flexion of one joint activating flexion or extension in the adjacent joints.…”

“…Srinivasan tenodesis uses a tendon graft sutured proximally to the EDC. [3][4][5] Another example of crossed dynamic tenodesis is the lateral band (Littler) tenodesis used to correct PIPJ hyperextension seen in swan-neck deformity. The lateral bands are routed palmar to the PIPJ and sutured to each other at the middle phalanx level to act as a check rein against PIPJ hyperextension.…”