A new method of tenotomy : by which the tendons are lengthened to a definite extent, instead of the present hap-hazard method / by W.W. Keen.
- William Williams Keen
- Date:
- 1891
Licence: Public Domain Mark
Credit: A new method of tenotomy : by which the tendons are lengthened to a definite extent, instead of the present hap-hazard method / by W.W. Keen. Source: Wellcome Collection.
Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.
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![[Reprinted from the Transactions of the College of Physicians of Philadelphia, 1891.] A NEW METHOD OF TEls^OTOMY, BY WHICH T TEI^DOITS ARE LE^v^GTHEi^ED TO A DEFimj EXTEi^T, mSTEAD OF THE PRESEN HAP-HAZARD METHOD. By W. W. keen, M.D., PROFESSOR OF THE PRIN'CIPLES OF SURGERY IN THE JEFFERSON MEDICA\. COLLEGE, [Read March 4, 1891.] I OWE the suggestion which, I believe, I carried out for the first time anywhere, to the fertile mind of my friend, Dr. S. Weir Mitchell, who has adorned every department of medi- cine which he has touched. The case in which I operated was one of post-hemiplegic contracture of the flexors of the fingers, kindly sent me by Dr. John Van Bibber, of Baltimore. Dr. Van Bibber sent the patient to me for an opinion as to a pos- sible operation of trephining for epilepsy, but I decided not to operate, as a careful investigation showed that the case was unsuitable. The fingers and thumb were markedly flexed into the palm of the hand, and Dr. Mitchell (who saw her with me) suggested that the contracture could be overcome by length- ening the tendons to a definite extent, instead of cutting them and allowing union to take place without any regulation of its amount. The patient was a lady, twenty-five years of age. The following operation was done November 29, 1890. An incision was made, beginning just above the pisiform bone and extending three inches obliquely upward, its upper end being over the tendon of the flexor carpi radialis. The edges of the wound, when pulled to one side, very readily exposed all the flexor tendons. Each tendon was first split in the middle one and a quarter inches and then, at the two ends of this incision, section of the opposite halves of the tendon](https://iiif.wellcomecollection.org/image/b22304885_0005.jp2/full/800%2C/0/default.jpg)
