Semitendinosus Tendon Graft for Hand Tendon Reconstruction

Background: Hand tendon reconstruction is required in both acute and chronic tendon injuries. A number of donor sites have been described; one such novel donor site is semitendinosus tendon used a graft for hand tendon reconstruction. Based on data reviewed, only a few cases are described up till now. Methods: Semitendinosus tendon was utilized in total of 18 patients undergoing tendon reconstruction for chronic tendon injuries and for tendon transfer to achieve adequate length. All cases were performed during January 2019 To December 2020. Full length uni/bilateral semitendinosus tendon was harvested using a tendon harvester. Tendon was used as a single slip or was split into further slips as needed for tendon reconstruction. Post operatively splints were continued as per protocol (keeping splint for 6 weeks, encouraging active physiotherapy at 8 weeks, continuing night splint age for total of 10 weeks and advising patient to avoid lifting heavy weight for at least 12 weeks). Patients were followed with assessment of strength via MRC (Medical Research Council) grading scale, and tendon excursion measurements via tip to palm distance. Results: Patients had a mean age for 27.5±2.3 with a predominant male population (72.2%). Post-operative assessment showed finger strength of MRC 5 in twelve patients and MRC 4 in three and MRC 3 in three patients. Tendon excursion was documented measuring a tip to palm distance. Three patients developed tendon adhesions which were treated with tenolysis. Conclusion: Semitendinosus is a recommended option for hand tendon (both flexor & extensor) reconstruction, providing adequate length & strength for reconstruction with high predictable availability and reliability. Although Palmaris longus remains the recommended option for single tendon reconstruction, it is absent in a few cases or is rudimentary, making it difficult to be utilized.