Purpose
To compare the semitendinosus and gracilis tendon lengths and diameters to the palmaris
longus, plantaris, flexor digitorum profundus, and flexor pollicis longus (FPL) tendons
in a cadaveric model to evaluate the feasibility of hamstring autograft use for staged
flexor tendon reconstruction.
Methods
Fifteen fresh cadavers were evaluated for surgical incisions about the knee, forearm,
and hand. All flexor digitorum profundus (FDP), FPL, palmaris longus, plantaris, semitendinosus,
and gracilis tendons were harvested from each specimen. Diameter and length were recorded
and means with SDs were calculated. The mean diameters of the gracilis and semitendinosus
were compared to the mean diameters of the FDP and FPL tendons. The hamstring tendon
lengths were then compared in terms of percentage of the palmaris longus and plantaris
tendon lengths.
Results
The gracilis (18.0 cm) and semitendinosus (19.9 cm) means were notably longer than
the palmaris longus (16.0 cm) and shorter than the plantaris (30.0 cm). The average
gracilis tendon diameter (3.8 mm) was smaller than the flexor tendon diameters except
for the little finger FDP (3.8 mm). The semitendinosus tendon diameter (4.8 mm) was
larger than all flexor tendons with the exception of the middle finger FDP (4.6 mm).
Average gracilis and semitendinosus tendon diameters were 3.7 mm and 4.5 mm in males,
and 3.8 mm and 4.8 mm in females.
Conclusions
This study showed the gracilis tendon to have adequate length and diameter for potential
autograft use in staged flexor tendon reconstruction in all digits but the little
finger. The semitendinosus is larger in diameter than the native flexor tendons, making
it a poor autograft option in cases with an intact pulley system.
Clinical relevance
Common tendon autograft options for flexor tendon reconstruction are variably present,
and the use of gracilis and semitendinosus autograft present potential graft options.
Key words
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Article info
Publication history
Published online: June 14, 2022
Accepted:
March 23,
2022
Received:
July 24,
2021
Publication stage
In Press Corrected ProofFootnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2022 by the American Society for Surgery of the Hand. All rights reserved.
