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Flexor tendon repair

Yoke-Rung Wong, Ita Suzana Mat Jais, Min-Kai Chang, Beng-Hai Lim, Shian-Chao Tay
BACKGROUND: This study evaluated the feasibility of using a low-profile titanium (Ti) plate implant, also known as the Ti-button, for Zone II flexor tendon repair. We hypothesize that the use of the Ti-button can distribute the tensile force on the digital flexor tendons to achieve better biomechanical performance. METHODS: Twenty lacerated porcine flexor tendons were randomly divided into two groups and repaired using Ti-button or 6-strand modified Lim-Tsai technique...
December 2018: Journal of Hand Surgery Asian-Pacific Volume
Min Kai Chang, Shian Chao Tay
BACKGROUND: Although flexor tendon injuries cause significant morbidities and socio-economic implications, there have been limited data on patient demographics, injury characteristics and surgical details. The aim of this study is to describe our experience in flexor tendon injuries and repairs. METHODS: We performed a retrospective study of all digital flexor tendon injuries that were repaired from January 2011 to December 2014. The collected data included patient demographics, injury characteristics and surgical details...
December 2018: Journal of Hand Surgery Asian-Pacific Volume
Rohit Singh, Jihad Alzyoud, Ryan Trickett, Peter Thomas, Peter Theobald, Ilyas Khan
BACKGROUND: Flexor tendon injuries are extremely common and they are usually the result of incised traumatic glass or knife injury. The process of tendon healing is a complicated and exceptionally-regimented mechanism that is originated and monitored by a vast number of diverse molecules. One of the most pivotal groups of mediators that are crucial to the healing process are growth factors (GF). Intense pulse light (IPL) can lead to evidence of new collagen formation with associated clinical improvement in tissue healing...
December 2018: Journal of Hand Surgery Asian-Pacific Volume
Chunjie Liu, Kunlun Yu, Jiangbo Bai, Dehu Tian, Guoli Liu
The adhesion of tendon and surrounding tissue is the most common complication after repairing an injured tendon. The injured flexor tendons in zone II are frequently accompanied by tendon sheath defects, which lead to poor recovery. A variety of biological and non-biological materials have been recently used for repair or as substitute for tendon sheaths to prevent tendon adhesion. However, non-biological materials, such as polyethylene films, have been used to prevent tendon adhesions by mechanical isolation...
2018: PloS One
Elizabeth M Polfer, Jennifer M Sabino, Ryan D Katz
We present an all-inside technique for zone I flexor tendon repair that combines suture anchor fixation with buried back-up fixation. The back-up fixation uses transosseous tunnels and a dorsal counterincision to allow a suture tied dorsal to the distal phalanx and buried. This technique is strong and permits early active range of motion. The dorsal tie-over does not require a suture button and, therefore, does not imperil the nail matrix. The surgical technique is herein described including the proposed anesthesia (wide awake), the incisions (midlateral), the exposures, and the repair itself...
October 8, 2018: Journal of Hand Surgery
Mohammed A Khalid, William M Weiss, Michael Iloanya, Vinod K Panchbhavi
BACKGROUND: Chronic Achilles tendon ruptures are uncommon and increase long-term morbidity when untreated. There is no standard treatment for this condition. METHODS: Chronic Achilles tendon rupture was repaired in 10 patients by harvesting the flexor hallucis longus tendon (FHL) using a minimally invasive technique. It was then transferred to the calcaneus and the remnant used to bridge the gap for reconstructing the Achilles tendon itself. The patients were assessed using the American Orthopaedic Foot and Ankle Score (AOFAS) Ankle-Hindfoot Scale...
October 11, 2018: Foot & Ankle Specialist
Naghmeh Poorpezeshk, Seyed Kamran Ghoreishi, Mohammad Bayat, Ramin Pouriran, Masoud Yavari
BACKGROUND: To obtain the best result from flexor tendon repair surgery, proper surgical technique, appropriate materials, good rehabilitation, and patient satisfaction are essential to consider. Nevertheless, no general unique protocol still exists between researchers, for a suitable treatment plan. OBJECTIVE: The aim of the present random clinical trial (RCT) was to determine the adjuvant effect of low-level laser therapy (LLLT) on healing tendon injury in patients...
October 2018: Photomedicine and Laser Surgery
Lasse Linnanmäki, Harry Göransson, Jouni Havulinna, Teemu Karjalainen, Olli V Leppänen
PURPOSE: To investigate factors that cause variation in the mechanical properties of flexor tendon repairs. METHODS: One surgeon repaired 50 homogeneous absorbent sticks and 40 porcine flexor tendons with a simple loop, an Adelaide repair, a peripheral over-and-over repair, or a combination of the latter 2 repairs. Ten hand surgeons repaired 1 porcine flexor tendon with the combined Adelaide core and over-and-over peripheral repair. We loaded the samples statically until failure and calculated the variations caused by the testing process, tendon substance, and surgical performance in terms of yield and ultimate load...
October 3, 2018: Journal of Hand Surgery
Susumu Yoneda, Hirotaka Okubo, Stephen W Linderman, Nozomu Kusano, Matthew J Silva, Stavros Thomopoulos, Fuminori Kanaya, Richard H Gelberman
The failure rate of intrasynovial tendon repair is high due to substantial elongation at the repair site and to the development of adhesions between the tendon's surface and the surrounding digital sheath. To minimize these complications, we sought to reduce the incidence of gapping and to facilitate the initiation of early motion by improving the time zero structural properties of repair. The Winters-Gelberman 8-strand repair technique was modified by adding surface lock loops and by using Fiberwire suture material...
2018: PloS One
Jae-Hwi Nho, Sang-Woo Lee, Mi-Ae Nam, Byung-Sung Kim, Ki Jin Jung
Avulsion fracture of the volar base of the distal phalanx is a rare injury. Zone 1 flexor tendon injuries can be treated with either internal or external fixation techniques. Pull-out suture repairs are often used for FDP tendon avulsion injuries. However, the pull out suture technique is associated with a number of well documented complications including nail bed injury and pressure necrosis. Despite the variety of techniques available for the repair of acute distal zone 1 flexor tendon injuries, no one technique has proven to be superior to all others...
September 2018: Journal of Hand Surgery Asian-Pacific Volume
Deepak Samson, Manish Gupta
BACKGROUND: The terminal phalanx of the fingers carries the attachment of the Flexor Digitorum Profundus (FDP) on the volar surface and the extensor on the dorsal surface. Avulsion of these tendons has traditionally been repaired with pull-through sutures. Recently, bone anchor sutures have been found to be of comparable biomechanical strength but with the added advantage of technical ease and fewer complications. However, the dimensions of the bone, at the site of insertion of the anchors, have never been studied...
September 2018: Journal of Hand Surgery Asian-Pacific Volume
Gokce Yildiran, Osman Akdag, Zekeriya Tosun
INTRODUCTION: Flexor tendon repair techniques that can resist active forces are widely accepted. Despite that many suture techniques have been described, the "perfect repair" for flexor tendons cannot be achieved yet. We aimed to compare a new loop suture technique with commonly used flexor tendon repair methods biomechanically in hen tendon. METHOD: We used 25 hen flexor tendons for each group (4-strand modified Kessler, grasping cruciate, Tsuge, and new technique groups)...
September 26, 2018: Annals of Plastic Surgery
Yuki Fujihara, Hideyuki Ota, Kentaro Watanabe
Central slip tears often occur with concomitant hand injuries. However, the outcome of a central slip tear and the effect of concomitant injuries are rarely reported. We evaluated 67 fingers in 63 patients with central slip tears who underwent primary surgery in our hospital between April 2009 and June 2017. We performed multivariate analyses, with proximal interphalangeal (PIP) joint active range of motion (AROM) and existing extension lag greater than 10° as dependent variables and age, existence of concomitant fractures, skin defects, collateral ligament injuries, ruptured lateral bands, ruptured flexor tendons or vascular injury in the injured finger as independent variables...
October 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Laurent Willemot, Filip R Hendrikx, Ann-Maria Byrne, Roger P van Riet
There has been an increase in thrower-specific elbow injuries in recent years. High valgus stresses during the late cocking and acceleration phases of throwing need to be compensated by the flexor pronator muscles as these can exceed the tensile strength of the medial collateral ligament complex. Prevention of injuries is the priority, with a focus on strengthening, reducing throwing frequency, decreasing force, and promoting a technique. The spectrum of thrower injuries ranges from a simple sprain to complete failure of the valgus stabilizing factors...
2018: Obere Extremität
Paweł Reichert, Aleksandra Królikowska, Maciej Kentel, Jarosław Witkowski, Jan Gnus, Wojciech Satora, Andrzej Czamara
PURPOSE: The studies comparing the fixation methods being used for the ruptured distal biceps brachii tendon reinsertion show similar outcomes of cortical button and suture anchors usage, however, longer follow-up studies remain necessary. The goal of this study was to compare the clinical and functional three-year outcomes of the cortical button in contrast to the suture anchor fixation. METHODS: A retrospective cohort study comprised of 28 males on average 3 years after surgical reinsertion of the distal biceps brachii tendon with the use of a cortical button (Group I, n = 11) or a suture anchor (Group II, n = 17)...
September 12, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Young-Keun Lee, Malrey Lee
RATIONALE: Spontaneous flexor pollicis longus (FPL) tendon rupture is rarely reported. Although there are several studies investigating spontaneous FPL tendon rupture, the exact etiology of spontaneous rupture is unclear. Here, we present a case of unusual spontaneous FPL tendon rupture due to tendolipomatosis. PATIENT CONCERNS: A 64-year-old right-handed retired male teacher was referred to our clinic with an inability to flex the interphalangeal joint of his left thumb...
September 2018: Medicine (Baltimore)
Jack G Graham, Mark L Wang, Michael Rivlin, Pedro K Beredjiklian
Tendon injuries of the hand that require surgical repair often heal with excess scarring and adhesions to adjacent tissues. This can compromise the natural gliding mechanics of the flexor tendons in particular, which operate within a fibro-osseous tunnel system similar to a set of pulleys. Even combining the finest suture repair techniques with optimal hand therapy protocols cannot ensure predictable restoration of hand function in these cases. To date, the majority of research regarding tendon injuries has revolved around the mechanical aspects of the surgical repair (i...
September 7, 2018: Connective Tissue Research
Teemu Karjalainen, Kaisa Jokinen, Sandeep J Sebastin, Toni Luokkala, Olli-Pekka Kangasniemi, Aleksi Reito
PURPOSE: Any loss of range of motion of the finger after flexor tendon repair is an impairment of function, but to what extent it causes disability is not properly understood. The aim of this study was to assess the correlation between perceived function (disability) and objectively measured loss of function (impairment), to understand what impairments are meaningful to patients. METHODS: We assessed 49 patients who underwent flexor tendon repair an average of 38 months after repair...
August 13, 2018: Journal of Hand Surgery
Alireza Yousefi, Farshid Sarrafzadeh-Rezaei, Siamak Asri-Rezaei, Amir-Abbas Farshid, Mehdi Behfar
Chitosan bears numerous properties, such as biocompatibility, biodegradability and non-toxicity making it suitable for use in different biomedical fields. Zinc (Zn) is required for fibroblasts proliferation and collagen synthesis as essential elements of wound healing. Its nanoparticles are well known for their capability to enhance wound healing by cell adhesion and migration improvement through growth factors-mediated mechanisms. Poor blood supply and unique histological characteristics of tendon make its regeneration always slow...
2018: Veterinary Research Forum
Bernd Hohendorff, C Knappwerth, J Franke, L P Müller, C Ries
INTRODUCTION: Stable pronator quadratus repair following volar plate fixation of distal radius fractures with complete plate coverage is difficult. MATERIALS AND METHODS: This study compares a modified pronator quadratus repair technique involving the brachioradialis muscle insertion (test group) with a conventional radial incision through the muscle without pronator quadratus repair (standard group). This prospective randomised study included 16 patients in the test group and 12 in the standard group; all were available for clinical, radiographic and ultrasound examination at a mean follow-up of 15 months...
October 2018: Archives of Orthopaedic and Trauma Surgery
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