| • The Approximator simplifies repairing or transferring tendons of all sizes in both upper and lower extremities. It absorbs the muscle pull so that the tension-free ends can be sewn with relative ease. |
| • It holds the tendon ends in an anatomically correct position to permit a more accurate repair. |
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ASSI®•LTA-2550
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Severed tendon. The Lalonde Tendon Approximator will be used to anatomically approximate the tendon ends without tension.
To safeguard against entanglement in the sutures, the approximator is placed in the wound, opposite the surgeon, where the tendon end can be safely secured by skewering it with a sterile 1" 22 gauge hypodermic needle.
Upon securing the remaining tendon end by skewering it with a secondary needle, the tendon ends are brought together by sliding the needle arms toward each other and securing them to the sliding bar by tightening the screws.
With the Approximator acting as a surgical assistant, the tendon ends have been anatomically approximated without tension. Forcep manipulation of the epitendon, which causes scarring, has been minimized.
The tendon ends can now be sewn with relative ease. This is accomplished by using a 4-0 Mersiline suture in the surgeon’s normal manner.
In this case a modified Bunnell suture has been used. The knot is securely tied to avoid tendon end gapping after the Approximator is removed.
A running 6-0 nylon peritenon suture is used on the anterior half of the tendon repair.
The Approximator is flipped over 180°. The posterior half of the tendon repair is now accessible for examining the anatomical accuracy of the repair or completing the epitendon running suture.
The tendon anastomosis is complete. The needles have been withdrawn from the Approximator, and the instrument has been removed.
Designed by D.H. Lalonde, B.Sc., M.Sc., M.D., FRCSC, Saint John, N.B., Canada
