TENDON TRANSPLANTATION IN REHABILITATION

• Tendon transplantation is a versatile and gratifying procedure if it is well planned, if the technique is meticulously followed, and if adequate thought is given to the postoperative care and training of the patient. The ideal situation is one in which the transplantation removes a deforming influence in one area and provides desired control in another. The tendon must be securely anchored in its new insertion, tension must be sufficient to hold the affected part in a desirable position, the muscle must exert its action in a straight line from origin to new insertion, it must not be required to work against a contracture, and it needs continued support in a somewhat overcorrected position. The postoperative care includes a program of assisted exercise, and careful nurturing of the transplant into its new function. Tendon transplants are most useful in flaccid paralyses like those after poliomyelitis, nerve injuries, and obstetric trauma.