Name of the Procedure:

Tenoplasty, with muscle transfer, with or without free graft, elbow to shoulder, single (Seddon-Brookes type procedure)

Summary

Tenoplasty with muscle transfer is a surgical procedure that involves repairing and restructuring tendons and muscles between the elbow and shoulder. This complex surgery may also involve using a free graft to facilitate proper healing and function.

Purpose

• Medical Condition: This procedure addresses tendon and muscle injuries or deficiencies in the elbow to shoulder region.
• Goals: Restore functionality and strength to the upper arm, improve the range of motion, and reduce pain and discomfort.

Indications

• Severe tendon injuries or ruptures.
• Consequences of congenital deformities or traumas affecting elbow to shoulder musculature.
• Patients experiencing significant loss of arm function or chronic pain due to tendon or muscle issues.

Preparation

• Patients may need to fast for several hours before the surgery.
• Adjustments to medications, particularly blood thinners.
• Preoperative diagnostic tests such as MRI or ultrasound to assess the damage and plan the procedure.

Procedure Description

1. The patient is positioned, and general anesthesia is administered.
2. An incision is made over the affected tendon and muscle area.
3. The damaged tendon and muscle tissues are exposed and assessed.
4. A muscle transfer technique is performed, possibly involving the use of a free graft.
5. The graft (if used) is carefully positioned and secured.
6. The incision is closed with sutures, and sterile dressings are applied.

Common tools and equipment include surgical scalpels, grafting materials, sutures, and fixation devices.

Duration

The procedure typically takes around 2-4 hours, depending on the complexity and extent of the repair needed.

Setting

Generally performed in a hospital's operating room or a specialized surgical center.

Personnel

• Lead surgeon specializing in orthopedic or reconstructive surgery.
• Anesthesiologist.
• Surgical nurses.
• Surgical assistants.

Risks and Complications

• Infection at the incision site.
• Blood clots.
• Nerve damage.
• Poor or delayed healing.
• Loss of graft or failure of muscle transfer.
• Persistent pain or limited functionality.

Benefits

• Improved arm strength and function.
• Better range of motion.
• Relief from chronic pain.
• Enhanced quality of life.

Recovery

• Initial hospital stay of 1-2 days.
• Instructions on keeping the surgical area clean and dry.
• Physical therapy to regain strength and mobility.
• Possible immobilization of the arm for several weeks.
• Follow-up appointments to monitor healing and outcomes.
• Full recovery can take several months.

Alternatives

• Non-surgical treatments like physical therapy or medications.
• Less invasive procedures such as arthroscopic surgery.
• Pros: Non-surgical options come with fewer risks and shorter recovery times.
• Cons: May not be as effective in severe cases or for restoring full function.

Patient Experience

• Patients will be under general anesthesia during the procedure, so they will not feel pain.
• Post-operative pain and soreness, managed with prescribed painkillers.
• Temporary discomfort or restrictions in arm movements.
• The use of slings or braces to support the healing process.
• Gradual increase in activities as strength and function improve through rehabilitation.