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Flexor tendon repair

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https://www.readbyqxmd.com/read/28920487/unilateral-dislocation-of-the-posterior-tibialis-tendon-ptt-and-flexor-digitorum-longus-tendon-with-contralateral-ptt-subluxation-in-a-patient-with-congenitally-shallow-flexor-groove
#1
Jacob E Waldron, Andrew S Bernhardson, Todd A Fellars
INTRODUCTION: Flexor tendon dislocation from the flexor tendon groove posterior of the medial malleolus has been previously described, and may be difficult to diagnose initially, but is amendable to surgical treatment with good outcomes. We present a unique case of unilateral dislocation of the posterior tibialis and flexor digitorum longus tendons with contralateral flexor digitorum longus subluxation that was treated surgically with a good outcome. CASE PRESENTATION: A 37-year-old active duty male sustained a dislocation and subluxation of the flexor tendons bilaterally after a forced dorsiflexion injury...
October 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28893531/a-systematic-review-of-plantar-plate-repair-in-the-management-of-lesser-metatarsophalangeal-joint-instability
#2
REVIEW
Mohammed Elmajee, Zhiyu Shen, Jamie A'Court, Anand Pillai
The plantar plate is a major structure that maintains metatarsophalangeal joint (MTPJ) stability and has only recently gained attention. Anatomic plantar plate repair can directly address the pathologic entity, rather than relying on indirect reduction of the MTPJ instability by osteotomy or tendon transfer techniques. The present report aimed to determine the effectiveness of plantar plate repair for the treatment of patients with lesser MTPJ instability. Different databases were searched using the guidelines in the Cochrane Handbook and recommendations from the Preferred Reporting Items for Systematic reviews and Meta-Analysis statement...
September 8, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28890257/effects-of-pdgf-bb-delivery-from-heparinized-collagen-sutures-on-the-healing-of-lacerated-chicken-flexor-tendon-in-vivo
#3
Mousa Younesi, Derrick M Knapik, Jameson Cumsky, Baris Ozgur Donmez, Ping He, Anowarul Islam, Greg Learn, Philip McClellan, Michael Bohl, Robert J Gillespie, Ozan Akkus
Flexor tendon lacerations are traditionally repaired by using non-absorbable monofilament sutures. Recent investigations have explored to improve the healing process by growth factor delivery from the sutures. However, it is difficult to conjugate growth factors to nylon or other synthetic sutures. This study explores the performance of a novel electrochemically aligned collagen suture in a flexor tendon repair model with and without platelet derived growth factor following complete tendon laceration in vivo...
September 7, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28835192/the-effect-of-adding-active-flexion-to-modified-kleinert-regime-on-outcomes-for-zone-1-to-3-flexor-tendon-repairs-a-prospective-randomized-trial
#4
István Zoltán Rigó, Jan-Ragnar Haugstvedt, Magne Røkkum
In a prospective randomized study, we studied whether adding active flexion to a modified Kleinert regime changed outcomes of flexor tendon repairs in zone 1, 2 and 3 in 73 fingers (53 patients). Evaluation included active range of finger motion, grip and pinch strengths. Twelve months after surgery, the increase in range of active finger motion after adding active flexion was insignificant compared with that with the modified Kleinert regime. According to the Strickland criteria, 20 out of 29 fingers had excellent or good recovery after adding active flexion, as did 28 out of 34 fingers with the modified Kleinert regime; we could not detect significant improvement of the good and excellent rate...
January 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28820835/simultaneous-stiles-bunnell-tendon-transfer-enhances-intrinsic-function-of-the-second-toe-transplantations
#5
Yu-Te Lin, Charles Yuen Yung Loh, Shwu-Huei Lien, Chih-Hung Lin, Fu-Chan Wei
Claw finger is sequelae of fingers without intrinsic function. Claw toe deformity is common after toe transfers as simultaneous intrinsic reconstruction has yet to be reported in the literature. We present our experience of simultaneous tendon transfers during the second toe transplantation. Seven 2nd toe transfers were performed in 5 metacarpal-like and metacarpal hands. The Stiles-Bunnell tendon transfer was incorporated into toe transfers. Toe lumbrical tendons were repaired to the Flexor Digitorum Sublimis of the same recipient digit...
August 8, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28819185/deletion-of-ep4-in-s100a4-lineage-cells-reduces-scar-tissue-formation-during-early-but-not-later-stages-of-tendon-healing
#6
Jessica E Ackerman, Katherine T Best, Regis J O'Keefe, Alayna E Loiselle
Tendon injuries heal via scar tissue rather than regeneration. This healing response forms adhesions between the flexor tendons in the hand and surrounding tissues, resulting in impaired range of motion and hand function. Mechanistically, inflammation has been strongly linked to adhesion formation, and Prostaglandin E2 (PGE2) is associated with both adhesion formation and tendinopathy. In the present study we tested the hypothesis that deletion of the PGE2 receptor EP4 in S100a4-lineage cells would decrease adhesion formation...
August 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28807348/a-biomechanical-comparison-between-asymmetric-pennington-technique-and-conventional-core-suture-techniques-6-strand-flexor-tendon-repair
#7
Naoya Kozono, Takamitsu Okada, Naohide Takeuchi, Takeshi Shimoto, Hidehiko Higaki, Yasuharu Nakashima
PURPOSE: To evaluate the fatigue strength and gap sizes of the asymmetric Pennington technique compared with 2 conventional 6-strand core suture techniques: the triple-looped suture and the Yoshizu #1. METHODS: We recorded the fatigue strength (forces × cycles) and gap sizes of a 6-strand flexor tendon repair with different core suture techniques under cyclic loading in 30 porcine tendons. The asymmetric Pennington technique was performed with a Pennington repair of equal suture purchase in the 2 tendon stumps, with the 2 other Pennington repairs shifted by 3 mm, respectively, along the longitudinal axis of the tendon in relation to the first Pennington repair...
August 11, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28802535/the-effects-of-autologous-platelet-rich-fibrin-on-flexor-tendon-healing-in-a-rabbit-model
#8
Janice C Y Liao, Min He, Aaron W T Gan, Alphonsus K S Chong
PURPOSE: Platelet-rich plasma containing large amounts of growth factors is purported to increase repaired flexor tendon strength. However, the use of bovine thrombin has the risk of antibody formation. We evaluated the effects of the newer generation autologous platelet-rich fibrin (PRF) on flexor tendon healing. METHODS: We performed surgical repair of 32 flexor tendons from the index and ring digits of the hind paws of 8 New Zealand white rabbits. In the PRF group, the PRF membrane was either wrapped around or interposed between the repair sites...
August 9, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28774241/an-experimental-model-on-the-biomechanical-behaviour-of-the-flexor-tendons-in-new-zealand-rabbits
#9
D Skouteris, E Magnissalis, A Papalois, S Varitimidis, P J Papagelopoulos, A B Zoubos
BACKGROUND: In order to introduce new pharmacological agents with the intent to inhibit the adhesion formation, it is important to test such products on laboratory animals under a protocol that can evaluate the quantitative and qualitative aspects of healing of the tendons. Most experimental models focus on the tensile strength and histological analysis of the tendons, failing to sufficiently quantify the degree of the adhesion formation. METHODS: The experiment included six male New Zealand rabbits that underwent surgery of their right forepaws...
September 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/28774235/animal-models-for-tendon-repair-experiments-a-comparison-of-pig-sheep-and-human-deep-flexor-tendons-in-zone-ii
#10
Tim Sebastian Peltz, Stuart William Hoffman, Peter James Scougall, Mark Peter Gianoutsos, Robert Savage, Rema Antoinette Oliver, William Robert Walsh
BACKGROUND: This laboratory study compared pig, sheep and human deep flexor tendons in regards to their biomechanical comparability. METHODS: To investigate the relevant biomechanical properties for tendon repair experiments, the tendons resistance to cheese-wiring (suture drag/splitting) was assessed. Cheese-wiring of a suture through a tendon is an essential factor for repair gapping and failure in a tendon repair. RESULTS: Biomechanical testing showed that forces required to pulling a uniform suture loop through sheep or pig tendons in Zone II were higher than in human tendons...
September 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/28740775/acute-a4-pulley-reconstruction-with-a-first-extensor-compartment-onlay-graft
#11
Michael G Jakubietz, Rainer H Meffert, Karsten Schmidt, Joerg G Gruenert, Rafael G Jakubietz
BACKGROUND: The integrity of the flexor tendon pulley apparatus is crucial for unimpaired function of the digits. Although secondary reconstruction is an established procedure in multi-pulley injuries, acute reconstruction of isolated, closed pulley ruptures is a rare occurrence. There are 3 factors influencing the functional outcome of a reconstruction: gapping distance between tendon and bone (E-space), bulkiness of the reconstruction, and stability. As direct repair is rarely done, grafts are used to reinforce the pulley...
June 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28728940/silicone-infusion-tubing-instead-of-hunter-rods-for-two-stage-zone%C3%A2-2-flexor-tendon-reconstruction-in-a-resource-limited-surgical-environment
#12
K Kibadi, F Moutet
The authors describe their experience using silicone infusion tubing in place of Hunter rods for two-stage zone 2 flexor tendon reconstruction in a resource-limited surgical environment. This case report features a 47-year-old, right-handed man who had no active PIP and DIP joint flexion in four fingers of the right hand 5 months after an injury. During the first repair stage, the A2 and A4 pulleys were reconstructed using an extensor retinaculum graft. An infusion tube was inserted instead of Hunter rods...
July 17, 2017: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/28718311/a-biomechanical-study-of-a-novel-asymmetric-6-strand-flexor-tendon-repair-using-porcine-tendons
#13
Yoke Rung Wong, Shian Chao Tay
BACKGROUND: This study evaluated the biomechanical performance of a novel asymmetric 6-strand flexor tendon repair technique without locking loops. METHODS: Twenty porcine flexor tendons were equally repaired by using the asymmetric technique and compared with the modified Lim-Tsai repair technique. The ultimate tensile strength, load to 1-mm gap force, stiffness, and mechanism of failure were measured. RESULTS: The asymmetric repair technique had significantly higher tensile strength (63...
January 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28709791/molecular-biology-of-flexor-tendon-healing-in-relation-to-reduction-of-tendon-adhesions
#14
REVIEW
Anais Legrand, Yoav Kaufman, Chao Long, Paige M Fox
Tendon injuries are encountered after major and minor hand trauma. Despite meticulous repair technique, adhesion formation can occur, limiting recovery. Although a great deal of progress has been made toward understanding the mechanism of tendon healing and adhesions, clinically applicable solutions to prevent adhesions remain elusive. The goal of this paper is to review the most recent literature relating to the tendon healing and adhesion prevention.
September 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28702884/decellularization-of-large-tendon-specimens-combination-of-manually-performed-freeze-thaw-cycles-and-detergent-treatment
#15
Susanne Pauline Roth, Ina Erbe, Janina Burk
Reliable decellularization techniques applicable to tendon tissue play a critical role in the field of current tissue engineering. Particularly, an application as three-dimensional culture model for in vitro research and translational approaches to establish graft-based tendon repair as a routine clinical tool represent two main application fields for decellularized tendon scaffolds. Considering methodological issues of tendon decellularization, one of the major challenges lies in the preservation of the tendon-specific extracellular matrix (ECM) architecture to reflect natural tissue characteristic as best as possible...
July 13, 2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28698915/surgical-treatment-of-stage-ii-posterior-tibialis-tendon-dysfunction-ten-year-clinical-and-radiographic-results
#16
Alberto Ruffilli, Francesco Traina, Sandro Giannini, Roberto Buda, Fabrizio Perna, Cesare Faldini
INTRODUCTION: Grade II chronic tibialis posterior tendon dysfunction (PTTD) poses a reconstructive challenge to the orthopaedic surgeon. Aim of this retrospective study is to report the clinical and radiographical results of a case series of 63 patients (102 ft) affected by grade II PTTD who underwent tailored surgical treatment at 10-year mean follow-up. MATERIALS AND METHODS: Sixty-three patients (102 ft) were available for clinical and radiological evaluation and were retrospectively reviewed at a mean follow-up of 125...
July 11, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28686669/obesity-type-ii-diabetes-alters-macrophage-polarization-resulting-in-a-fibrotic-tendon-healing-response
#17
Jessica E Ackerman, Michael B Geary, Caitlin A Orner, Fatima Bawany, Alayna E Loiselle
Type II Diabetes (T2DM) dramatically impairs the tendon healing response, resulting in decreased collagen organization and mechanics relative to non-diabetic tendons. Despite this burden, there remains a paucity of information regarding the mechanisms that govern impaired healing of diabetic tendons. Mice were placed on either a high fat diet (T2DM) or low fat diet (lean) and underwent flexor tendon transection and repair surgery. Healing was assessed via mechanical testing, histology and changes in gene expression associated with collagen synthesis, matrix remodeling, and macrophage polarization...
2017: PloS One
https://www.readbyqxmd.com/read/28673623/primary-flexor-tendon-repair-with-early-active-motion-experience-in-europe
#18
REVIEW
Thomas Giesen, Maurizio Calcagni, David Elliot
The protocol for primary flexor tendon repair in zones 1 and 2 of the hand is changing. This article discusses recent changes. Immediate repair within 48 hours is performed whenever possible. A 6-strand core suture is performed using the M modification of Tang's technique. The pulleys are divided to allow free excursion of the repaired tendon within the tendon sheath. To avoid repaired structures within the sheath being too bulky, the authors generally repair only half of the flexor digitorum superficialis...
August 2017: Hand Clinics
https://www.readbyqxmd.com/read/28673622/strong-digital-flexor-tendon-repair-extension-flexion-test-and-early-active-flexion-experience-in-300-tendons
#19
REVIEW
Jin Bo Tang, Xiang Zhou, Zhang Jun Pan, Jun Qing, Ke Tong Gong, Jing Chen
Over the past 2 decades, repair and rehabilitation methods of primary repair of the digital flexor tendon have changed. In this article, we outline interim results from ongoing investigations in several units. Surgeons in these units now perform digital flexor tendon repairs according to a treatment protocol. Before adopting the protocol, they had no history of tendon-related research; they had not used any of the repair and rehabilitation methods described in the protocol. The surgeons involved are junior or midlevel attending surgeons...
August 2017: Hand Clinics
https://www.readbyqxmd.com/read/28671883/prevention-of-peritendinous-adhesion-formation-after-the-flexor-tendon-surgery-in-rabbits-a-comparative-study-between-use-of-local-interferon-%C3%AE-interferon-%C3%AE-and-5-fluorouracil
#20
Mohammad Javad Fatemi, Shahram Shirani, Roohollah Sobhani, Amir Hossein Lebaschi, Mohammad Javad Gharegozlou, Tooran Bagheri, Mirsepehr Pedram, Mohsen Saberi, Shirin Araghi, Mohammad Ali Fatemi
BACKGROUND: Peritendinous adhesion is the most common complication after tendon surgery, particularly in zone II of the hand. Prevention of inflammation around the tendon, which develops after trauma and surgery, can decrease the tendon adhesion formation. This study compares the effect of some anti-inflammatory cytokines with 5-fluorouracil (5-FU) on the tensile strength and in prevention of peritendinous adhesion formation. METHODS: Sixteen rabbits were allocated equally into 4 groups...
June 1, 2017: Annals of Plastic Surgery
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