Classification of the main tenodesis techniques used in hand surgery.

The authors put forward a simple classification of the main types of tenodesis used in hand surgery. This classification is based on the theoretical mechanical effects of different tenodesis techniques. It separates simple tenodesis, which overrides only one joint, from dynamic tenodesis, which crosses two or more joints, and further subdivides "direct" and "crossed" dynamic tenodesis. Direct tenodesis is situated on the same side as the rotation axis of the joints, whereas crossed tenodesis crosses those rotation axes. The concept of "reciprocal" tenodesis effect is also introduced. Many different examples are used to illustrate this classification, with appropriate illustrations.