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A D V E R T I S E M E N T
A D V E R T I S E M E N T
Performing the myodesis of the deep flexor muscles to the radius and ulna: two drill holes are made only in the volar cortex of the radius and ulna ends aiming toward the cut surface. A non-absorbable suture on a small curved needle is passed from the medial side of the volar surface of the FDP/FPL group, through the medial bone tunnel in the ulna and out the end of the marrow cavity. It is then passed in through the lateral bone tunnel from the marrow side and up through the FDP/FPL group adjacent to the starting point. Passing the suture through tendons when possible substantially increases the strength of the myodesis. The process is then repeated on the radius.
A D V E R T I S E M E N T
The lateral and medial sutures are tied, securing the deep flexor group, providing secure bulk coverage of the bone ends. Tourniquet release at this time will allow for hemostasis of bleeding muscle and missed blood vessels, preventing hematoma/seroma complications.
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A D V E R T I S E M E N T
The extensor muscles are pulled out to length to ensure bone coverage. Often the EDC and mobile wad (ECRB, ECRL and brachioradialis) are sewn together to better contour the myoplasty over the radius and ulna. This can be done before or after the extensor and flexor muscles are brought together. Two non-absorbable sutures are passed through the tendinous portion of the superficial flexor group, passed horizontally through the tendinous portion of the reflected extensor digitorum communis under mild tension, then back up through the superficial flexor group. The two sutures are thus passed through four tendons when possible.
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This page was last modified on 6/15/2011.
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