Extensor tenodesis for plexic hands with C7 to T1 or C8, T1 root avulsions: a new technique.

In C7 to T1 or C8, T1 root avulsion palsies, restoration of finger active extension is not possible. Only tenodesis may restore hand opening in active wrist flexion. Many techniques have been described to restore this motion. In routine techniques, extensor tendons are fixed on radius or sutured on dorsal retinaculum. However, in these procedures, progressive tendon lengthening or ruptures may occur and salvage procedure may be difficult to perform. Therefore, we proposed a new extensor tenodesis technique. The extensor digitorum communis tendons are sutured on the paralyzed flexor digitorum superficialis tendons through interosseous membrane. This procedure allows performing a strong tendon to tendon suture more resistant than radius or retinaculum fixation. As other tenodesis techniques, wrist flexion has to be active to obtain hand opening.