Surgical Planning for Flexor Digitorum Longus Tendon Transfers: An Anatomic Study
Surgical Planning for Flexor Digitorum Longus Tendon Transfers: An Anatomic Study
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DOI：
10.1053/j.jfas.2016.09.002
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发表时间：
2017
影响因子：
1.3
通讯作者：
Jeffrey E. McAlister;Shyler L. DeMill-;Eric So;Christopher F. Hyer
中科院分区：
文献类型：
--
作者：
Jeffrey E. McAlister;Shyler L. DeMill-;Eric So;Christopher F. Hyer
摘要 胫骨后肌腱功能障碍常伴有不同程度的后足外翻和马蹄足畸形。术前计划对于适当的手术选择和手术效率至关重要。本研究的目的是评估指长屈肌腱移植收获部位的解剖结构，特别是亨利主结处。使用三十具新鲜冰冻的膝以下尸体进行解剖。采用标准解剖方法进行胫骨后肌腱清创和指长屈肌腱转移。在亨利主结处收获并测量指长屈肌腱。目前的解剖学研究评估了常见收获部位的指长屈肌腱的肌腱宽度。在 30 个样本中，20 个（67%）测量为 5 毫米，10 个（33%）测量为 4 毫米。每个样本都可以接受 5.0 毫米的干涉螺钉，因此是最安全的选择。只有 33% 的样本可以接受 4.0 毫米的干涉螺钉。在收获现场，雄性的趾长屈肌腱比雌性稍强健。这些信息将有助于外科医生在胫骨后肌腱功能障碍的 II 期平足矫正期间进行术前计划。 &NA;临床证据等级：5
Abstract Posterior tibial tendon dysfunction is often coupled with various degrees of hindfoot valgus and equinus. Preoperative planning is essential to appropriate procedure choice and surgical efficiency. The purpose of the present study was to assess the anatomy at the harvest site for flexor digitorum longus tendon transfer, specifically at the master knot of Henry. Thirty fresh‐frozen below‐the‐knee cadavers were used for dissection. A standard anatomic approach was performed for posterior tibial tendon debridement and flexor digitorum longus tendon transfer. The flexor digitorum longus tendon was harvested and measured at the master knot of Henry. The present anatomic study evaluated the tendon width of the flexor digitorum longus tendon at a common harvest site. Of the 30 specimens, 20 (67%) measured 5 mm and 10 (33%) measured 4 mm. A 5.0‐mm interference screw would be acceptable in each specimen and therefore would be the safest choice. A 4.0‐mm interference screw would be acceptable in only 33% of the specimens. Males have a slightly more robust flexor digitorum longus tendon than females at the harvest site. This information will assist surgeons in preoperative planning during stage II flatfoot correction for posterior tibial tendon dysfunction. &NA; Level of Clinical Evidence: 5