TENOTOMY (Greek tenon a sinew, a vein + tome a section, a section) — the operation consisting in a section of a sinew.
T. lengthenings of a sinew by the four-head of a muscle of a hip before an arthroplasty of a knee joint or a tricipital muscle — before an arthroplasty of an elbow joint can be independent operation or a part of more difficult surgery, napr (see. Arthroplasty ).
The most frequent indications to T. the resistant flexion contracture of a knee joint, the flexion and bringing contractures of a hip joint, a muscular wryneck, horse foot are.
Depending on the line of section of T. can be cross, longitudinal, slanting, Z-shaped, on a way of carrying out — closed and opened.
The closed T. it is made by special tenotomes through cuts punctures of skin. The T can be so produced. Achilles tendon (see), and also sinews of adductors of a hip. At the same time the hip is given the provision of assignment and in the stretching sinew do a puncture by a curved tenotome. Then the tenotome is carried out under a sinew to its opposite edge, turned an edge to a sinew and cut it, without injuring skin. Extremities give the provision of hyper correction, a cut hold a plaster bandage.
Open T. make through a section of skin in a sinew under control of sight and a finger. So it is necessary to carry out T. sinews of a sgibately shin at a flexion contracture in a knee joint and grudino - a clavicular and mastoidal muscle at a wryneck in connection with danger of damage of nearby neurovascular educations.
See also Sinews .
Bibliography: The multivolume guide to orthopedics and traumatology, under the editorship of> N. P. Novachenko, t. 1, page 413, M., 1967; Chaklin V. D. Fundamentals of operational orthopedics and traumatology. 236, 619, M., 1964.
L. N. Bryantseva.