title: Modified Long Toe Extensor Tendon Harvest for Use as Intercalary Graft in Upper Extremity Reconstruction.
abstract: Autograft tendon harvested from the long toe extensors are of great utility as intercalary grafts in upper extremity reconstruction. However, standard full-length harvest is complicated by the presence of extensor retinacula and multiple juncturae between adjacent extensors, which often necessitate extensive dissection, increasing the potential for morbidity. We describe a modified technique for partial harvest of the long toe extensors, which is performed entirely proximal to the superior extensor retinaculum. This technique requires a single incision and provides adequate length of graft for the majority of forearm to fingertip reconstructions. The technique is described in the context of our preliminary cadaver findings, with a case example provided to further illustrate the utility of this technique.
authors.affiliation: Philadelphia Hand Center, PC, Department of Orthopedic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA. Electronic address: michaelpgaspar@gmail.com.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Gaspar
authors.affiliation: Philadelphia Hand Center, PC, Department of Orthopedic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA; Department of Orthopedic Surgery, University of Rochester Medical Center, Rochester, NY.
authors.forename: Danielle M
authors.initials: DM
authors.lastname: Wilbur
authors.affiliation: Department of Orthopaedic Surgery, University of Cincinnati, Cincinnati, OH.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Stern
authors.affiliation: Philadelphia Hand Center, PC, Department of Orthopedic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA.
authors.forename: Randall W
authors.initials: RW
authors.lastname: Culp
mesh_terms: D002102:Cadaver; D004210:Dissection; D005543:Forearm Injuries / Q000601:surgery*; D006214:Hallux / Q000601:surgery*; D006230:Hand Injuries / Q000601:surgery*; D006801:Humans; D013710:Tendons / Q000601:surgery / Q000637:transplantation*; D020858:Tissue and Organ Harvesting / Q000379:methods*; D014182:Transplantation, Autologous
keywords: Long toe extensor; extensor digitorum longus; intercalary graft; modified tendon harvest; upper extremity reconstruction