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Flexor tendon repair

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https://www.readbyqxmd.com/read/29145347/fingertip-winding-suture-pull-out-suture-technique-for-flexor-tendon-repair-in-zone-i
#1
Mostafa Mahmoud, Motaz Elian, Abdalah Seif Elnasr
Injuries to flexor tendons in zone I has always been challenging during repair. Over the time several techniques were developed and modified to achieve the highest repair strength and thus the best functional outcome. These techniques vary from pull-out sutures with internal and external fixation to the use of bone anchors. All techniques were accompanied with advantages and disadvantages as well as postoperative morbidities related to certain techniques. In the present technique we introduce a subperiosteal pull-out suturing technique...
December 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/29134318/the-impact-of-different-peripheral-suture-techniques-on-the-biomechanical-stability-in-flexor-tendon-repair
#2
B Wieskötter, M Herbort, M Langer, M J Raschke, D Wähnert
PURPOSE: Flexor tendon repair consists of circumferential peripheral sutures in combination with core sutures to avoid fraying and reduces the exposure of suture material on tendon surface. The peripheral suture adds up to a tenfold increase of the biomechanical stability compared to the core suture alone. The purpose of our study was to determine the most favourable peripheral repair technique for tendon repair. METHODS: Seventy-two porcine flexor tendons underwent standardized tenotomy and repair using one of the following six methods (n = 12): simple-running (SR), simple-locking (SL), Halsted-mattress (HM), lin-locking (LL), Lembert-mattress (LM), and Silfverskiöld cross-stich (SCS) suture technique...
November 13, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29110725/tendon-split-lengthening-technique-for-flexor-hallucis-longus-tendon-rupture
#3
Jae Yong Park, Chenyu Wang, Hee Dong Kim, Hyong Nyun Kim
BACKGROUND: Flexor hallucis longus (FHL) tendon rupture is a challenging injury to lead with clawing of the great toe when the FHL tendon is repaired too tight. When the diagnosis is delayed, the tendon ends may not be opposable because of contracture or poor tendon tissue. METHODS: A technique to reconstruct FHL tendon rupture without a free tendon graft is described. A split tendon lengthening is performed at the midfoot around the knot of Henry. Ankle block anesthesia is used to allow the patient's active movement of the interphalangeal (IP) joint to determine the appropriate length of the reconstructed tendon for maintaining balance and preventing the tendon from being too tight or too loose...
November 6, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29101976/repair-of-pronator-quadratus-with-partial-muscle-split-and-distal-transfer-for-volar-plating-of-distal-radius-fractures
#4
REVIEW
Hui-Kuang Huang, Jung-Pan Wang, Ming-Chau Chang
Flexor tendon injury is a rare, but serious, complication after volar plate fixation for distal radius fractures. The plate position and prominence at the watershed line are contributing factors that cause flexor tendon injury. With the standard volar approach, the pronator quadratus (PQ) is typically elevated off the radial attachment. The distal part of the plate is often visible after repair of the PQ. We describe a "PQ-splitting" technique for covering the distal edge of the plate if primary PQ repair cannot completely cover the distal part of the plate...
November 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29095192/interposition-tendon-graft-and-tension-in-the-repair-of-closed-rupture-of-the-flexor-digitorum-profundus-in-zone-iii-or-iv
#5
Young Jun Kim, Jong Hun Baek, Jin Sung Park, Jae Hoon Lee
We report the results of interposition tendon grafts using the ipsilateral palmaris longus tendon in 12 patients with closed flexor digitorum profundus tendon ruptures in zone III or IV of 14 digits between June 2006 and October 2015. Before surgery, 2 patients were diagnosed with closed tendon ruptures that occurred after nonunion of hamate hook fractures. The other 10 patients were diagnosed with spontaneous tendon ruptures of unknown cause. In 2 of the 10 patients with spontaneous tendon rupture, the cause of the rupture was not found...
October 31, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29078827/insertional-tendinopathy-of-the-achilles-debridement-primary-repair-and-when-to-augment
#6
REVIEW
Rachel J Shakked, Steven M Raikin
Insertional Achilles tendinopathy is a degenerative enthesopathy associated with pain and dysfunction. Nonsurgical management is first attempted for a period of 3 to 6 months and may consist of physical therapy with eccentric training and other modalities. Surgical treatment can be successful with a variety of approaches. A thorough debridement through a midline tendon-splitting approach is associated with high satisfaction rates. Flexor hallucis longus transfer to augment the repair is considered in older, heavier patients or if more than 50% of the tendon was debrided...
December 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/29069263/a-biomechanical-analysis-of-the-interlock-suture-and-a-modified-kessler-loop-lock-flexor-tendon-suture
#7
Wenfeng Yang, Dan Qiao, Yuanfei Ren, Yvjin Dong, Yaohua Shang, Tiehui Zhang
OBJECTIVE: In this work, we attempted to develop a modified single-knot Kessler-loop lock suture technique and compare the biomechanical properties associated with this single-knot suture technique with those associated with the conventional modified Kessler and interlock suture techniques. METHODS: In this experiment, a total of 18 porcine flexor digitorum profundus tendons were harvested and randomly divided into three groups. The tendons were transected and then repaired using three different techniques, including modified Kessler suture with peritendinous suture, interlock suture with peritendinous suture, and modified Kessler-loop lock suture with peritendinous suture...
October 2017: Clinics
https://www.readbyqxmd.com/read/29065767/results-of-heterodigital-flexor-digitorum-profundus-hemi-tendon-transfer-for-23-flexor-tendon-injuries-in-zones-1-or-2
#8
Aude Bommier, Duncan McGuire, Patrick Boyer, Asan Rafee, Sami Razali, Christophe Oberlin
We report outcomes of reconstruction of zone 1 or 2 flexor tendon injuries using a heterodigital hemi-tendon transfer of the flexor digitorum profundus in 23 fingers of 23 patients. At mean follow-up of 57 months, the mean total active motion of the three finger joints including the metacarpophalangeal joint was 128 degrees preoperatively and 229 degrees at final follow up. According to Strickland criteria, the function was excellent for 14 fingers, good for seven fingers and poor for two fingers. The subgroup analysis showed that the results were better in cases of primary surgery, children, and for the index and little fingers...
January 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/29039270/commentary-on-the-effect-of-adding-active-flexion-to-modified-kleinert-regime-on-outcomes-for-zone-1-to-3-flexor-tendon-repairs-a-prospective-randomized-trial
#9
Xiang Zhou, Jing Chen
No abstract text is available yet for this article.
November 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28993165/motor-sparing-continuous-median-nerve-block-for-hand-surgery-a%C3%A2-pediatric-case
#10
Takeshi Murouchi
Here is described a successful perioperative pain control with continuous median nerve block after flexor tendon repair surgery on 2nd finger of a child. A 9-year-old patient was admitted for reconstruction surgery. The combination of median nerve block and lateral/medial antecubital cutaneous nerve blocks were performed before the surgery to cover all the surgical incision including the 2nd finger, palm, the graft site proximal to the wrist, and Kleinert traction at the nail bed. At the end of the surgery, the infusion catheter was inserted at the distal one-third to spare the muscle strength of flexor digitorum muscles...
September 22, 2017: Asian J Anesthesiol
https://www.readbyqxmd.com/read/28985979/feasibility-of-a-new-pulley-repair-a%C3%A2-cadaver-study
#11
Isabelle Schöffl, Julia Meisel, Christoph Lutter, Volker Schöffl
PURPOSE: In this study, the feasibility of a new pulley reconstruction in which the tendon graft is pulled through a tunnel in the proximal phalanx, was evaluated using a cadaver model, with particular attention paid to the weakening of the bone structure by the drill hole. METHODS: Nine fingers from 6 cadaver hands with intact pulley systems were compared with 9 fingers from 6 cadaver hands with missing A2 to A4 pulleys but that included a repair using the new surgical technique...
October 4, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28975818/relative-motion-flexion-splinting-for-flexor-tendon-lacerations-proof-of-concept
#12
Bryan Chung, David T W Chiu, Vishal Thanik
BACKGROUND: The principle of relative motion has allowed patients to regain a higher degree of hand function, while protecting extensor tendon repairs. The purpose of this study was to determine whether the principle of relative motion could be a viable method to protect a flexor tendon repair. METHODS: Four fresh-frozen cadaver arms were each mounted on a testing apparatus (wrist in 30° of extension, metacarpophalangeal [MCP] joints blocked to 70°-80°). A minimum of 11 N was used to cyclically load the flexor digitorum profundus and extensor digitorum communis tendons to maximum allowable flexion and extension for 25 cycles...
October 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28967444/cyclic-testing-of-the-6-strand-tang-and-modified-lim-tsai-flexor-tendon-repair-techniques
#13
Gavrielle Hui-Ying Kang, Yoke-Rung Wong, Rebecca Qian-Ru Lim, Austin Mun-Kitt Loke, Shian-Chao Tay
PURPOSE: In this study, we compared the Tang repair technique with the 6-strand modified Lim-Tsai repair technique under cyclic testing conditions. METHODS: Twenty fresh-frozen porcine flexor tendons were randomized into 2 groups for repair with either the modified Lim-Tsai or the Tang technique using Supramid 4-0 core sutures and Ethilon 6-0 epitendinous running suture. The repaired tendons were subjected to 2 stage cyclic loading. The survival rate and gap formation at the repair site were recorded...
September 26, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28960382/ultrasonographic-evaluation-of-zone-ii-partial-flexor-tendon-lacerations-of-the-fingers-a-cadaveric-study
#14
Nikolas H Kazmers, Joshua A Gordon, Kristen L Buterbaugh, David J Bozentka, David R Steinberg, Viviane Khoury
OBJECTIVES: Accurate assessment of zone II partial flexor tendon lacerations in the finger is clinically important. Surgical repair is recommended for lacerations of greater than 50% to 60%. Our goal was to evaluate ultrasonographic test characteristics and accuracy in identifying partial flexor tendon lacerations in a cadaveric model. METHODS: From fresh-frozen above-elbow human cadaveric specimens, 32 flexor digitorum profundus tendons were randomly selected to remain intact or receive low- or high-grade lacerations involving 10% to 40% and 60% to 90% of the radioulnar width within Verdan Zone II, respectively...
September 29, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28926379/tendon-length-calf-muscle-atrophy-and-strength-deficit-after-acute-achilles-tendon-rupture-long-term-follow-up-of-patients-in-a-previous-study
#15
Juuso Heikkinen, Iikka Lantto, Juuso Piilonen, Tapio Flinkkilä, Pasi Ohtonen, Pertti Siira, Vesa Laine, Jaakko Niinimäki, Ari Pajala, Juhana Leppilahti
BACKGROUND: In this prospective study, we used magnetic resonance imaging (MRI) to assess long-term Achilles tendon length, calf muscle volume, and muscle fatty degeneration after surgery for acute Achilles tendon rupture. METHODS: From 1998 to 2001, 60 patients at our center underwent surgery for acute Achilles tendon rupture followed by early functional postoperative rehabilitation. Fifty-five patients were reexamined after a minimum duration of follow-up of 13 years (mean, 14 years), and 52 of them were included in the present study...
September 20, 2017: Journal of Bone and Joint Surgery. American Volume
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
#16
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
#17
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...
November 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
#18
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...
November 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
#19
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...
November 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
#20
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
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