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Flexor tendon repair

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https://www.readbyqxmd.com/read/28423932/comparing-biomechanical-properties-repair-times-and-value-of-common-core-flexor-tendon-repairs
#1
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
#2
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 3-27 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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/28216811/silicone-foley-s-catheter-as-an-effective-alternative-to-hunter-s-rod-in-staged-flexor-tendon-reconstruction-of-the-hand
#11
Tawheed Ahmad, Sheikh Adil Bashir, Mohammad Inam Zaroo, Adil Hafeez Wani, Saima Rashid, Summaira Jan
CONTEXT: Staged flexor tendon reconstruction is most suitable treatment method for extensive zone II tendon injuries. The Hunter's rod used in this procedure is costly and not easily available, which adds to the miseries of both patients as well as treating surgeon. AIMS: The aim of this study is to evaluate the results of staged zone II flexor tendon repair using silicone Foley's catheter as a cheaper and readily available alternative to Hunter's rod. SETTINGS AND DESIGN: This was a prospective study...
September 2016: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/28205484/a-biomechanical-comparison-of-different-knots-tied-on-fibrewire-suture
#12
Jackson Jiang, Ita Suzana Mat Jais, Andrew Kean Tuck Yam, Duncan Angus McGrouther, Shian Chao Tay
BACKGROUND: Synthetic sutures such as Fiberwire used in flexor tendon repairs have high tensile strength. Proper application allows early mobilisation, decreasing morbidity from repair rupture and adhesions while preserving range of motion. Suture stiffness can cause poorer knot holding, contributing to gapping, peritendinous adhesions or rupture. Previous studies recommended more throws in knots tied on Fiberwire to prevent knot slippage. These larger knots are voluminous and prominent...
March 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/28205481/a-comparison-of-two-monofilament-suture-materials-for-repair-of-partial-flexor-tendon-lacerations-a-controlled-in-vitro-study
#13
Abhinav Gulihar, Thomas Whitehead-Clarke, Ladan Hajipour, Joe J Dias
BACKGROUND: Surgical repair is advocated for flexor tendon lacerations deeper than 70%. Repair can be undertaken with different suturing techniques and using different materials. Different materials used for tendon repair will have a different gliding resistance (GR) at the joint. Previous studies have compared strength of repair and gliding resistance for various braided suture materials and for 100% laceration of flexor tendons. We directly compare the GR of two monofilament sutures when used for a peripheral running suture repair of partially lacerated tendons...
March 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/28196433/outcomes-of-the-six-strand-m-tang-repair-for-zone-2-primary-flexor-tendon-repair-in-54-fingers
#14
X Zhou, X R Li, J Qing, X F Jia, J Chen
We repaired complete divisions of flexor tendons in zone 2 in 54 fingers using a six-strand core M-Tang repair method. Partial active digital motion started with early passive digital motion carried out first in the first 3-4 weeks after surgery and full range of active motion in later weeks. The patients were followed for 4-27 months. According to Strickland criteria or Tang criteria, 24 (83%) had excellent or good, four fair and one poor results in 28 fingers with follow-up of more than one year. In the other 25 fingers which were followed for less than 12 months, 19 (76%) had excellent and good, four fair and two poor results...
February 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28149218/does-barbed-suture-repair-negate-the-benefit-of-peripheral-repair-in-porcine-flexor-tendon
#15
Alan Sull, Serkan Inceoglu, Montri D Wongworawat
Background: Advances in suture material and geometry have fueled interest in barbed suture tenorrhaphy. Theoretically, barbed suture allows better load distribution, smoother gliding under pulleys, and improved tendon blood flow. Minimal data exist on whether barbed tendon repair may benefit from supplementation by a peripheral stitch. The purpose of this study is to determine whether peripheral suture repair increases gap resistance in both conventional and barbed core repairs, increases maximum tensile strength, and fails before or after the core repair...
December 2016: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28149217/comparison-of-barbed-sutures-in-porcine-flexor-tenorrhaphy
#16
Alan Sull, Serkan Inceoglu, Alicia August, Stephen Gregorius, Montri D Wongworawat
Background: Barbed suture use has become more popular as technology and materials have advanced. Minimal data exist regarding performance of the 2 commercially available products, V-LocTM and StratafixTM in tendon repairs. The purpose of this study was to compare gap resistance and ultimate tensile strength of both suture materials and nonbarbed suture in a porcine ex vivo model. Methods: Porcine flexor tendons were harvested and divided into 3 groups of 10 of varying suture material (3-0 PDS™, 3-0 V- V-Loc 180™, or 3-0 Stratafix™)...
December 2016: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28135230/team-approach-repair-and-rehabilitation-following-flexor-tendon-lacerations
#17
Nathan T Morrell, Anne Hulvey, Jennifer Elsinger, George Zhang, Adam B Shafritz
No abstract text is available yet for this article.
January 10, 2017: JBJS Reviews
https://www.readbyqxmd.com/read/28092337/anatomical-basis-and-clinical-application-of-synovial-flaps-in-the-wrist-and-distal-forearm
#18
David L Colen, Jiun-Ting Yeh, Lawrence B Colen
Neuropathic symptoms after median nerve repair at the wrist or secondary to refractory carpal tunnel syndrome may become debilitating. These symptoms develop due to perineural adhesions, intraneural fibrosis and fixation of the nerve to the transverse carpal ligament after surgery and often require neurolysis. Interposition of vascularized soft tissue over the median nerve at the time of neurolysis prevents recurrence of such adhesions. The synovial flap, fashioned from the synovial lining of the flexor tendon sheath, is an ideal tissue for this purpose...
January 12, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28042226/cell-and-biologic-based-treatment-of-flexor-tendon-injuries
#19
Stephen W Linderman, Richard H Gelberman, Stavros Thomopoulos, Hua Shen
The two primary factors leading to poor clinical results after intrasynovial tendon repair are adhesion formation within the digital sheath and repair-site elongation and rupture. As the outcomes following modern tendon multi-strand repair and controlled rehabilitation techniques are often unsatisfactory, alternative approaches, such as the application of growth factors and mesenchymal stem cells (MSCs), have become increasingly attractive treatment options. Successful biological therapies require carefully controlled spatiotemporal delivery of cells, growth factors, and biocompatible scaffold matrices in order to simultaneously (1) promote matrix synthesis at the tendon repair site leading to increased biomechanical strength and stiffness and (2) suppress matrix synthesis along the tendon surface and synovial sheath preventing adhesion formation...
September 2016: Operative Techniques in Orthopaedics
https://www.readbyqxmd.com/read/28026732/-spontaneous-tendon-ruptures-in-the-rheumatoid-hand
#20
REVIEW
J Pech, D Veigl, M Vlček
A spontaneous tendon rupture is a direct consequence of rheumatoid inflammation and can appear without any noticeable impact, often during sleep. The patient then presents with inability to flex or extend metacarpophalageal or interphalangeal joints. Multiple ruptures resulting in impaired function of several fingers can also occur and markedly limit the hand's grip strength. A tear may arise from either mechanical injury to the tendon along its course over bone or connective tissues, or by biochemical action of lysosomal enzymes, released during the inflammation process, on the connective tissue of the tendon...
2016: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
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