gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

Article

Send article

Basic operative informations in three main aetiological causes which necessitate tendon transfers in upper extremity

Meeting Abstract

Search Medline for

  • Fatih Aydin - University of Mersin, School of Medicine, Department of Orthopaedics and Traumatology, Mersin, Turkey
  • Ender Gümüsoglu - University of Mersin, School of Medicine, Department of Orthopaedics and Traumatology, Mersin, Turkey
  • presenting/speaker Kadir Uzel - University of Mersin, School of Medicine, Department of Orthopaedics and Traumatology, Division of Hand Surgery, Mersin, Turkey
  • Metin Manouchehr Eskandari - University of Mersin, School of Medicine, Department of Orthopaedics and Traumatology, Division of Hand Surgery, Mersin, Turkey

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-1673

doi: 10.3205/19ifssh0293, urn:nbn:de:0183-19ifssh02938

Published: February 6, 2020

© 2020 Aydin et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objectives/Interrogation: Tendon transfers (TTs) are the last treatment options indicated in patients with three main aetiologies. These are peripheral nerve palsies (PNP), local loss of muscle-tendon units without nerve injuries (LLMTU) and muscle imbalances due to central nervous system dysfunctions (MICNSD). In this study we aimed to analyse timing, number of transferred tendons and need of additional surgical procedures (ASPs) in patients who underwent TTs on the base of their aetiologies.

Methods: Digital archive of the university hospital between May 2007 and September 2018 was searched. Informative data required by the aims of the study were compiled.

Results and Conclusions: There were 112, 53 and 24 patients in each group of PNP, LLMTU and MICNSD, respectively. The most frequent diagnosis, transferred tendon and additional procedure in PNP was Brachial plexus palsy (n=39), PL-EPL (n=29) and nerve release (n=12); in LLMTU was Closed EPL rupture (n=19), EIP-EPL (n=19) and Tendon release or plication (n=4); and in MICNSD was Cerebral palsy (n=20), PT rerouting and FCU-EDC (n=6 in each) and Muscle-tendon fractional release (n=16), orderly and respectively. Other findings are given below. Findings in each line are belonging to PNP, LLMTU and MICNSD groups respectively. Time data is given as "mean (min,max)". PNPs include both neonatal and adult type brachial plexus palsies.

  • Gender (men/Women): 87/25, 37/16, 15/9
  • Age at 1. surgery (year): 26 (3-70), 37 (8-74), 19 (7-44)
  • Onset-1. surgery interval (month): 58 (1-300), 24 (1-228), 202 (24-444)
  • Total n of TTs: 193, 68, 46
  • n of TTs/patient: (1,7), (1,3), (1,9)
  • n of operations/patient: (1,1), (1,05), (1,08)
  • Field of the most frequent ASP and its n:
  • ASP-Nerve: 32, 0, 0
  • ASP-Muscle-tendon-pulley: 35, 4, 17
  • ASP-Bone-joint: 8, 2, 2
  • ASP-Skin (1.webplasty): 3, 2, 3
  • Total ASPs & n/patient: 78 (0,7), 8 (0,15), 22 (0,92)

Conclusions: Tendon transfers can be successful when it is well-planned on the base of patient's physical resources, goals, and expectations. For these aims, patients should be adequately informed about the timing, probability of additional procedures, necessity for further operation sessions and possible complications. We think that informations provided by this study can be useful while informing patients on the base of their three main etiological problems.