About ten years ago, the writer arrived at a stage in the practice of surgical relief of paralytic residual imbalance in which the application of certain physical and kinetic principles seemed logically to point to fairly precise indications for selection and utilization of muscle and tendon transference in a given presenting situation of paralytic residuals. Since then, 300 operations have been performed with these principles in mind, and it has been possible to check up on the results three or more years after operation in 215 of these cases. The results have been analyzed according to function and statics, with conclusions and indications derived from the findings in five of the most common and sharply defined situations. Tendon transposition has proved to be a most useful procedure in restoration of lost function, and frequently an imperative procedure in the prevention and control of imbalance deformity. Its utilization diminishes the frequency and the extent of stiffening procedures, sometimes as an adjunct to them and sometimes as a preferable substitute for them. Its success is as much dependent on the meticulous evaluation of the presenting static, dynamic, and kinetic conditions as on the technique of the operative procedure.
(C) 1938 All Rights Reserved.The Journal of Bone and Joint Surgery, Inc.