A study on correlation between surface measurement of limbs and underlying tendon grafts used for reconstructive surgeries
Authors: Chaitra B. R*,Anitha M. R,Tarakeshwari R,Shailendranath M. S
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Introduction: Tendon transfer restores balance to the hand which has lost its power due to tendon or muscle destruction. There are various factors which are taken into account while selecting a graft for reconstructive surgeries such as availability, length, expendability of graft tendon. The purpose of this study is to correlate the surface measurement of upper limb and lower limb using anatomical landmarks and underlying tendon lengths used for grafting. This will provide an idea for estimation of underlying donor tendon lengths by easily measured surface measurements of upper and lower limbs.
Materials and Methods: The study was conducted on 30 cadaveric upper and lower limbs collected in the department of anatomy, AIMS&RC, Devanahalli, Bengaluru. Lengths of commonly harvested tendons used for grafting were measured. In upper limb, tendons of palmaris longus, extensor digiti minimi and extensor indices were selected. In lower limb, tendons of plantaris and extensor digitorum longus of 2nd toe were selected. Surface measurement of upper limb and lower limbs were measured using bony land marks. Correlation between surface measurement of limbs and lengths of underlying tendons used for grafting were analyzed. By using, the univariate least square regression model, tendon multiplier is generated for each tendon, which gives the tendon length in donors by using the surface measurements of upper and lower limbs.
Results: Mean tendon lengths of palmaris longus is 15.53±4.7 cm, extensor digiti minimi is 19.7±1.9 cm, extensor indices is 19.1±1.2 cm, plantaris is 35.97±2.7 cm and extensor digitorum longus of second toe is 27.93±2.9 cm. Tendon multiplier for the tendon of palmaris longus is 0.66, for extensor digiti minimi is 0.53, for extensor indices is 0.31, for plantaris is 0.91 and extensor digitorum longus is 0.51. Mean surface measurement of upper limb is 27.5±2.31 cm and lower limb is 37.43± 2.6 cm.
Conclusion: While selecting tendons for graft, length of donor tendon is a limiting variable. Using the easily available surface measurements, surgeons may be able to better estimate the underlying tendon lengths available for grafting.