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Flexor tendon repair

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https://www.readbyqxmd.com/read/28506172/the-effect-of-myostatin-gdf-8-on-proliferation-and-tenocyte-differentiation-of-rat-bone-marrow-derived-mesenchymal-stem-cells
#1
Wei Le, Jeffrey Yao
BACKGROUND: The future in flexor tendon surgery involves tissue engineering approaches directed toward increasing early repair strength to accelerate tendon healing and to allow for earlier onset of rehabilitation. Previous work has shown that pluripotential mesenchymal stem cells may be successfully delivered to a tendon repair site using a suture carrier. The current work describes the use of Myostatin (GDF-8) to help guide these delivered pluripotential stem cells to differentiate down a tenocyte lineage to potentially maximize the reparative effects of these cells at the tendon repair site...
June 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/28506161/symmetric-peripheral-running-sutures-are-superior-to-asymmetric-peripheral-running-sutures-for-increasing-the-tendon-strength-in-flexor-tendon-repair
#2
N Takeuchi, T Okada, N Kozono, T Shimoto, H Higaki, Y Iwamoto
BACKGROUND: The fatigue strength of three peripheral suture techniques for flexor tendon repair was compared by cyclic loading of the repairs in the porcine flexor digitorum tendon. METHODS: Thirty-six tendons were sutured using only peripheral sutures with 6-0 Nylon. An initial cyclic load of 10 N for 500 cycles was applied and increased by 10 N for an additional 500 cycles at each new load until rupture. RESULTS: The fatigue strength of the symmetric running peripheral suture was 85...
June 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/28501463/home-based-rehabilitation-in-the-postoperative-treatment-of-flexor-tendon-repair
#3
M Sanmartín-Fernández, B Fernández-Bran, J Couceiro-Otero
OBJECTIVE: To evaluate the results and complications of flexor tendon repair in which a home-based rehabilitation program was utilized without the assistance of a hand therapist during the first 4postoperative weeks. MATERIAL Y METHODS: Between July 2009 and July 2014, a total of 21 digits in 15 patients were treated in our institution for complete laceration of the flexor tendons within the flexor pulley system (zone 1 and 2). Passive and active exercises performed by the patients themselves were started the morning after the operation...
May 10, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/28501340/epitendinous-first-repair-of-zone-ii-flexor-digitorum-profundus-results-in-decreased-gliding-resistance
#4
Michael G Galvez, Garet C Comer, Arhana Chattopadhyay, Chao Long, Anthony W Behn, James Chang
PURPOSE: The importance of flexor tendon repair with both core and epitendinous suture placement has been well established. The objective of this study was to determine whether suture placement order affects gliding resistance and bunching in flexor digitorum profundus tendons in a human ex vivo model. METHODS: The flexor digitorum profundus tendons of the index, middle, ring, and little fingers of paired cadaver forearms were tested intact for excursion and mean gliding resistance in flexion and extension across the A2 pulley...
May 11, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28488452/biomechanical-investigation-of-uneven-load-bearing-in-six-strand-lim-tsai-flexor-tendon-repair-using-fiberloop-%C3%A2
#5
R A S Hay, Y R Wong, A M Loke, S C Tay
We hypothesized that, in providing biomechanical strength, at least one of the two middle strands in a modified six-strand Lim-Tsai flexor tendon repair could be divided without obvious reduction in repair strength owing to uneven load bearing. A total of 40 porcine flexor digitorum profundus tendons were repaired using the six-strand Lim-Tsai technique with a 4-0 FiberLoop(®) suture and then divided into four equal groups. (no cut, one middle strand cut, both middle strand cut, one side strand cut). The biomechanical performance of repaired tendons was tested and found to vary according to the location of the cuts...
June 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28476400/postoperative-repeat-dislocation-of-the-posterior-tibial-tendon-a-case-report
#6
Yasunari Ikuta, Nobuo Adachi, Tomoyuki Nakasa, Mitsuo Ochi
Dislocation of the posterior tibial tendon is an uncommon condition. Although surgery is usually performed in most cases of posterior tibial tendon dislocation, postoperative repeat dislocation of the posterior tibial tendon has not been reported in the published data. We report the case of a 27-year-old male patient who experienced repeat dislocation of the posterior tibial tendon after a gymnastic landing, 44 months after initial retinaculum repair. For revision surgery, we reconstructed the flexor retinaculum in conjunction with deepening of the retromalleolar groove, because the groove was hypoplastic...
May 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28467577/evaluation-of-forearm-arterial-repairs-functional-outcomes-related-to-arterial-repair
#7
Musa Kemal Keleş, Tekin Şimşek, Veysel Polat, Engin Yosma, Ahmet Demir
BACKGROUND: There are few studies of single forearm arterial injury repair that compare long-term results of intact and obliterated forearm arterial repair. Aim of the present study was to compare long-term results of forearm arterial repair using Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) score and color Doppler ultrasound (CDUS). METHODS: Records of 166 consecutive patients with forearm arterial injury were reviewed, and 30 patients with same injury (ulnar artery, ulnar nerve, and tendon injuries at flexor zone V) were called back for CDUS and QuickDASH scoring...
March 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28462460/combined-administration-of-ascs-and-bmp-12-promotes-an-m2-macrophage-phenotype-and-enhances-tendon-healing
#8
Richard H Gelberman, Stephen W Linderman, Rohith Jayaram, Anna D Dikina, Shelly Sakiyama-Elbert, Eben Alsberg, Stavros Thomopoulos, Hua Shen
BACKGROUND: Outcomes after intrasynovial tendon repair are highly variable. An intense inflammatory cascade followed by a delayed healing response can cause adhesion formation and repair-site failure that severely impair the function of repaired digits. No effective remedies exist to fully address these issues. Cell- and growth factor-based therapies have been shown to modulate inflammation and improve cell proliferation and matrix synthesis and therefore are promising treatment approaches for intrasynovial tendon repair...
May 1, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28453343/acute-isolated-flexor-tendon-laceration-associated-with-a-distal-radius-fracture
#9
J Ryan Hill, Ram K Alluri, Alidad Ghiassi
BACKGROUND: Subacute rupture of the flexor tendons secondary to distal radius fractures is well documented. Recently, accounts of flexor tendon rupture following open reduction internal fixation have been associated with volar plate fixation. However, discovery of an occult traumatic flexor tendon laceration during fixation of an acute distal radius fracture is not well described. This case indicates the importance of careful preoperative and intraoperative examination of the flexor tendons in the setting of comminuted distal radius fractures...
May 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28442075/passive-stiffness-of-the-ankle-and-plantar-flexor-muscle-performance-after-achilles-tendon-repair-a-cross-sectional-study
#10
Pollyana R T Borges, Thiago R T Santos, Paula R S Procópio, Jessica H D Chelidonopoulos, Roberto Zambelli, Juliana M Ocarino
BACKGROUND: Deficits in ankle muscle strength and ankle stiffness may be present in those subjects who underwent surgical treatment for an Achilles tendon rupture. The presence of these long-term deficits may contribute to a lower performance during daily activities and may be linked to future injuries. OBJECTIVE: To compare the ankle passive stiffness and the plantar flexor muscle performance in patients who underwent unilateral surgical treatment of Achilles tendon rupture with nonsurgical subjects...
January 2017: Brazilian Journal of Physical Therapy
https://www.readbyqxmd.com/read/28423932/comparing-biomechanical-properties-repair-times-and-value-of-common-core-flexor-tendon-repairs
#11
Aakash Chauhan, Patrick Schimoler, Mark C Miller, Alexander Kharlamov, Gregory A Merrell, Bradley A Palmer
BACKGROUND: The aim of the study was to compare biomechanical strength, repair times, and repair values for zone II core flexor tendon repairs. METHODS: A total of 75 fresh-frozen human cadaveric flexor tendons were harvested from the index through small finger and randomized into one of 5 repair groups: 4-stranded cross-stitch cruciate (4-0 polyester and 4-0 braided suture), 4-stranded double Pennington (2-0 knotless barbed suture), 4-stranded Pennington (4-0 double-stranded braided suture), and 6-stranded modified Lim-Tsai (4-0 looped braided suture)...
April 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28419543/aging-does-not-alter-tendon-mechanical-properties-during-homeostasis-but-does-impair-flexor-tendon-healing
#12
Jessica E Ackerman, Ibrahima Bah, Jennifer H Jonason, Mark R Buckley, Alayna E Loiselle
Aging is an important factor in disrupted homeostasis of many tissues. While an increased incidence of tendinopathy and tendon rupture are observed with aging, it is unclear whether this is due to progressive changes in tendon cell function and mechanics over time, or an impaired repair reaction from aged tendons in response to insult or injury. In the present study, we examined changes in the mechanical properties of Flexor Digitorum Longus (FDL), Flexor Carpi Ulnaris (FCU), and tail fascicles in both male and female C57Bl/6 mice between 3 and 27 months of age to better understand the effects of sex and age on tendon homeostasis...
April 17, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28399642/acute-tears-of-the-tibialis-posterior-tendon-following-ankle-sprain
#13
Lyle T Jackson, Linda J Dunaway, Gregory A Lundeen
BACKGROUND: Traumatic tears of the tibialis posterior (TP) tendon following an ankle sprain are rare. The purpose of this study was to report our case series of TP tendon tears following an ankle sprain. METHODS: Patients with persistent TP tendon pain after an ankle sprain were retrospectively identified over a 4-year period and reviewed. A comparison of magnetic resonance imaging (MRI) interpretations by a radiologist and surgeon was made. Patients failing conservative management underwent operative repair of the TP tendon tear and concomitant pathology...
April 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28370152/long-term-outcome-of-an-intra-articular-allograft-technique-for-treatment-of-spontaneous-cranial-cruciate-ligament-rupture-in-the-dog
#14
Jeffery J Biskup, Daniel G Balogh, Ruth M Scott, Michael G Conzemius
OBJECTIVE: To determine the 12-month outcome in dogs with spontaneous cranial cruciate ligament (CCL) rupture after repair with an intra-articular decellularized allograft. STUDY DESIGN: Prospective pilot case series. ANIMALS: Ten client-owned dogs with unilateral CCL rupture. METHODS: An intra-articular, decellularized, deep digital flexor tendon allograft was secured in the stifle with a femoral cross pin and tibial spiked washers and screws...
March 31, 2017: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/28365148/outcomes-after-flexor-tendon-repair-combined-with-the-application-of-human-amniotic-membrane-allograft
#15
Olli V Leppänen, Teemu Karjalainen, Harry Göransson, Annika Hakamäki, Jouni Havulinna, Jyrki Parkkinen, Jarkko Jokihaara
PURPOSE: Clinically proven methods to prevent adhesion formation after flexor tendon repair have not yet been established. The aim of this pilot study was to assess the feasibility of amniotic membrane allograft as a mechanical barrier to decrease adhesion formation. METHODS: Ten patients having flexor tendon injuries were planned to be recruited to the pilot study. The operative treatment consisted of tendon repair and fixation of amniotic membrane allograft around the repaired tendon...
March 29, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28291150/acquired-constriction-ring-a-case-of-rubber-band-syndrome
#16
Rahel Meier, Luzian Haug, Carsten Surke, Lukas Mathys, Esther Vögelin
Rubber band syndrome is a rare entity seen in younger children mainly in communities where rubber bands are worn around the wrist for decorative purposes. When the band is worn for a long duration, it burrows through the skin and soft tissues resulting in distal edema, loss of function, and even damage to the neurovascular structures. These symptoms are difficult to relate to this rare but typical condition. We report a case of a 2¾-year-old girl with the history of a linear circumferential scar at the right wrist combined with the limited use of a swollen hand for several weeks...
March 13, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28257673/midsubstance-tendinopathy-surgical-management
#17
REVIEW
William T DeCarbo, Mark J Bullock
Noninsertional Achilles tendinopathy often responds to nonoperative treatment. When nonoperative treatment fails, the clinician must distinguish between paratendinopathy and noninsertional tendinopathy. In paratendinopathy, myofibroblasts synthesize collagen, causing adhesions, and the paratenon may be released or excised. If a core area of tendinopathy is identified on MRI, the area is excised longitudinally and repaired with a side-to-side suture. If greater than 50% of the tendon diameter is excised, the authors recommend a short flexor hallucis longus tendon transfer with an interference screw...
April 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/28242243/effect-of-the-optimal-asymmetry-on-the-strength-of-six-strand-tendon-repair-an-ex%C3%A2-vivo-biomechanical-study
#18
Naoya Kozono, Takamitsu Okada, Naohide Takeuchi, Takeshi Shimoto, Hidehiko Higaki, Yasuharu Nakashima
PURPOSE: To evaluate the mechanical properties of a 6-strand core suture repair with asymmetric purchase in the 2 tendon ends, in comparison with a repair with symmetric suture purchases. METHODS: Under cyclic loading of the tendons, we recorded the fatigue strength (Forces × Cycles) of a 6-strand flexor tendon repair with different symmetry in the lengths of suture purchase in 60 porcine tendons. The symmetric repair was made with 3 groups of parallel Kessler repairs of equal suture purchase (10 mm from the cut end) in the 2 tendon stumps...
February 24, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28224209/-suture-techniques-and-material-in-surgery-of-flexor-tendons
#19
T Pillukat, R Fuhrmann, J Windolf, J van Schoonhoven
Adhesions and scar formation between flexor tendons and the surrounding tissue are only contemporarily avoidable by movement of flexor tendons. Concepts with active follow-up protocols are more favorable than passive mobilization. The main risks of flexor tendon repair are rupture of the tendon suture, insidious gap formation and resistance to tendon gliding within the tendon sheath. Currently, there is no consensus with respect to the optimal suture technique or suture material. Nevertheless, there are some principles worth paying attention to, such as using stronger suture material, blocking stitches, suture techniques with four or more strands as well as circular running sutures...
February 21, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28221337/modulation-of-digital-flexor-tendon-healing-by-vascular-endothelial-growth-factor-gene-transfection-in-a-chicken-model
#20
W F Mao, Y F Wu, Q Q Yang, Y L Zhou, X T Wang, P Y Liu, J B Tang
A major challenge in tendon injury is the weak intrinsic healing capacity of tendon that may cause rupture of the repair after surgery. Growth factors are believed to be critical during tendon healing. This study aimed to investigate the effects of vascular endothelial growth factor (VEGF) genes delivered by adeno-associated virus (AAV) vectors on tendon healing and molecular events involved in a chicken model. A total of 128 deep flexor tendons in the long toes of chickens were completely transected and injected with 2 × 10(9) particles of AAV2-VEGF or saline before surgically repaired...
April 2017: Gene Therapy
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