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Journal of Bone and Joint Surgery - British Volume, Vol 87-B, Issue 4, 583-587.
doi: 10.1302/0301-620X.87B4.15393  
Copyright © 2005 by British Editorial Society of Bone and Joint Surgery
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Response of the tendon during limb lengthening

G. Szöke, MSc(Oxon), PhD, Assistant Professor1; S.-H. Lee, Associate Professor2; A. H. R. W. Simpson, FRCS, Professor of Orthopaedic Surgery3; and J. Prescott, BSc, MSc, PhD, MBCS, CStat, Professor3

1 Orthopaedic Department of Semmelwers University, Karolina Street 27, Budapest, Hungary, H-1113.
2 Department of Orthopaedic Surgery, Korea University, Anam Hospital, 5-Ga, 126-1, Anam-dong, Sungbuk-ku, Seoul 136-075, Korea.
3 Musculoskeletal Research Unit, Pathology Building Level 3, University of Edinburgh, Teviot Place, Edinburgh EH8 9AG, UK.

Correspondence should be sent to Professor A. H. R. W. Simpson; e-mail: hamish.simpson{at}ed.ac.uk

Little is known about the increase in length of tendons in postnatal life or of their response to limb lengthening procedures. A study was carried out in ten young and nine adult rabbits in which the tibia was lengthened by 20% at two rates 0.8 mm/day and 1.6 mm/day.

The tendon of the flexor digitorum longus (FDL) muscle showed a significant increase in length in response to lengthening of the tibia. The young rabbits exhibited a significantly higher increase in length in the FDL tendon compared with the adults. There was no difference in the amount of lengthening of the FDL tendon at the different rates. Of the increase in length which occurred, 77% was in the proximal half of the tendon.

This investigation demonstrated that tendons have the ability to lengthen during limb distraction. This occurred to a greater extent in the young who showed a higher proliferative response, suggesting that there may be less need for formal tendon lengthening in young children.




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T. Shisha, S. Kiss, K. Pap, H. Simpson, and G. Szoke
Relative ability of young and mature muscles to respond to limb lengthening
J Bone Joint Surg Br, December 1, 2006; 88-B(12): 1666 - 1669.
[Abstract] [Full Text] [PDF]


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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General