# Sliding intercalated autograft for tendon defect reconstruction – The elongation rail technique (ERT)

## TL;DR

A new surgical technique called the Elongation Rail Technique uses a local tendon autograft to reconstruct tendon defects, avoiding donor-site issues and showing good results in early trials.

## Contribution

The novel Elongation Rail Technique uses a local sliding autograft to reconstruct tendon defects without distant graft harvesting.

## Key findings

- The technique was successfully applied in four patients with flexor tendon defects.
- Functional outcomes at 6 months were favorable according to Strickland and Glogovac criteria.

## Abstract

Tendon defect reconstruction is a challenging procedure that can be complicated by tendon retraction or tendon gap increase after debridement of interposed scar tissue. Although application of tendon autografts from dispensable tendons is considered the gold standard for bridging the gap, donor-site morbidity cannot be ignored. We use a local sliding tendon autograft which can avoid distant graft harvesting and it is adaptable across all tendon zones for reconstruction of tendon defects. A reverse l-type longitudinal incision of the same length with the measured final gap is made at the midsubstance of the proximal tendon stump and the created intercalary tendon segment is transferred distally to bridge the gap, providing an “elongated” proximal stump of the required length. The Elongation Rail Technique has been applied successfully in four patients with flexor tendon defects with favorable results and functional outcome at 6 months follow-up according to Strickland and Glogovac criteria.