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Flexor tendon repair

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https://www.readbyqxmd.com/read/28092337/anatomical-basis-and-clinical-application-of-synovial-flaps-in-the-wrist-and-distal-forearm
#1
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
#2
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
#3
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
https://www.readbyqxmd.com/read/28004174/altered-patterns-of-displacement-within-the-achilles-tendon-following-surgical-repair
#4
Åsa Fröberg, Ann-Sophie Cissé, Matilda Larsson, Mattias Mårtensson, Michael Peolsson, Tomas Movin, Anton Arndt
PURPOSE: Ultrasound speckle tracking was used to compare tendon deformation patterns between uninjured and surgically repaired Achilles tendons at 14-27-month follow-up. The hypothesis was that the non-homogenous displacement pattern previously described in uninjured tendons, where displacement within deep layers of the tendons exceeds that of superficial layers, is altered following tendon rupture and subsequent surgical repair. METHODS: In the first part of this study, an in-house-developed block-matching speckle tracking algorithm was evaluated for assessment of displacement on porcine flexor digitorum tendons...
December 21, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/27975032/flexor-tendon-repair-postoperative-rehabilitation-the-saint-john-protocol
#5
Amanda Higgins, Donald H Lalonde
The Saint John Protocol describes a rehabilitation program of up to half a fist of protected true active finger flexion beginning 3 to 5 days after flexor tendon repair. We no longer use full fist place and hold. We illustrate with film and text the reasons for these changes.
November 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/27975005/eight-strand-cross-locked-cruciate-flexor-tendon-repair-using-double-stranded-suture-a-description-of-the-surgical-technique
#6
Kentaro Watanabe, Hideyuki Ota, Hiroshi Sasaki
This article describes a technique for improved repair of digital flexor tendon laceration. Eight-strand cross-locked cruciate repair using 4-0 caliber double-stranded suture is not bulky and has a smooth configuration for tendon gliding. Additionally, it has sufficient strength for early postoperative active motion exercise.
November 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/27964900/zone-ii-flexor-tendon-repairs-in-the-united-states-trends-in-current-management
#7
Peter D Gibson, Garret L Sobol, Irfan H Ahmed
PURPOSE: The repair of zone II flexor tendon injuries is an evolving topic in hand surgery with current literature suggesting the use of a 4-strand repair; 3-0 or 4-0 braided, nonabsorbable sutures; and an epitendinous repair. It was hypothesized that variability would exist within the hand surgeon community in treatment of zone II flexor tendon repairs in surgical material used, surgical technique, and postoperative rehabilitation protocol. METHODS: An online single-answer multiple-choice survey was distributed to the American Society for Surgery of the Hand members' database...
December 10, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27885382/mri-in-flexor-tendon-rupture-after-collagenase-injection
#8
Shruti Khurana, Vibhor Wadhwa, Avneesh Chhabra, Bardia Amirlak
Flexor tendon rupture is an unusual complication following collagenase injection to relieve contractures. These patients require a close follow-up and in the event of tendon rupture, a decision has to be made whether to repair the tendon or manage the complication conservatively. The authors report the utility of MRI in the prognostication and management of a patient with Dupuytren's contracture, who underwent collagenase injection and subsequently developed flexor digitorum profundus tendon rupture.
February 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/27881830/repair-of-chronic-achilles-ruptures-has-a-high-incidence-of-venous-thromboembolism
#9
Mark J Bullock, William T DeCarbo, Mark H Hofbauer, Joshua D Thun
: Background Despite the low incidence of deep vein thrombosis (DVT) in foot and ankle surgery, some authors report a high incidence of symptomatic DVT following Achilles tendon rupture. The purpose of this study was to identify DVT risk factors inherent to Achilles tendon repair to determine which patients may benefit from prophylaxis. Methods One hundred and thirteen patient charts were reviewed following elective and nonelective Achilles tendon repair. For elective repair of insertional or noninsertional Achilles tendinopathy, parameters examined included lateral versus prone positioning and the presence versus absence of a flexor hallucis longus transfer...
November 23, 2016: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/27881441/evaluation-of-the-histological-and-mechanical-features-of-tendon-healing-in-a-rabbit-model-with-the-use-of-second-harmonic-generation-imaging-and-tensile-testing
#10
E Hase, K Sato, D Yonekura, T Minamikawa, M Takahashi, T Yasui
OBJECTIVES: This study aimed to evaluate the histological and mechanical features of tendon healing in a rabbit model with second-harmonic-generation (SHG) imaging and tensile testing. MATERIALS AND METHODS: A total of eight male Japanese white rabbits were used for this study. The flexor digitorum tendons in their right leg were sharply transected, and then were repaired by intratendinous stitching. At four weeks post-operatively, the rabbits were killed and the flexor digitorum tendons in both right and left legs were excised and used as specimens for tendon healing (n = 8) and control (n = 8), respectively...
November 2016: Bone & Joint Research
https://www.readbyqxmd.com/read/27879606/improving-outcomes-in-tendon-repair-a-critical-look-at-the-evidence-for-flexor-tendon-repair-and-rehabilitation
#11
Wee S Khor, Martin F Langer, Richard Wong, Rui Zhou, Fiona Peck, Jason K F Wong
LEARNING OBJECTIVES: After reading this article, the participant should be able to: 1. Appreciate the variation and evolution of flexor tendon management 2. Know how to assess the patient who presents with a flexor tendon laceration. 3. Understand the biology of repairing flexor tendon lacerations. 4. Appreciate the technical challenges in flexor tendon repair relating to different zones. 5. Understand the rationale of postoperative hand therapy. 6. Have an overview of the types of secondary tendon surgery...
December 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27851667/outcomes-after-primary-repair-and-staged-reconstruction-of-zone-i-and-ii-flexor-tendon-injuries-in-children
#12
Samantha L Piper, Lesley C Wheeler, Janith K Mills, Marybeth Ezaki, Scott N Oishi
BACKGROUND: Delayed diagnosis of flexor tendon injury in children is common, and consequent flexor sheath scarring may necessitate a 2-stage reconstruction. Previous studies show variable outcomes after 2-stage flexor reconstruction in children, especially those below 6 years old. We evaluated functional and subjective outcomes of primary repair and staged reconstruction of zone I and II tendon injuries in children under 6 years of age. METHODS: A retrospective chart review identified 12 digits in 10 patients who had undergone surgical treatment of a zone I or II flexor tendon injury...
November 15, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27847806/surgical-strategy-for-the-chronic-achilles-tendon-rupture
#13
Yangjing Lin, Liu Yang, Li Yin, Xiaojun Duan
Background. Chronic Achilles tendon rupture is usually misdiagnosed and treated improperly. This study aims to better understand the treatment of chronic Achilles tendon rupture. Methods. Patients who were not able to perform a single-limb heel rise were chosen. Pre- and postoperative magnetic resonance imaging (MRI) were conducted. By evaluating the presence or absence of Achilles tendon stumps and the gap length of rupture, V-Y advancement, gastrocnemius fascial turndown flap, or flexor halluces longus tendon transfer were selected for tendon repair...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27795781/-digital-replantation-results-and-complications-study-of-a-series-of-18-cases
#14
Mohammed El Idrissi, Abdelhalim Elibrahimi, Mohammed Shimi, Abdelmajid Elmrini
Digital amputations are frequent injuries, the majority of them are caused by workplace accidents. Microsurgical techniques are an alternative option to repair these amputations. This study aims to report our experience in digital replantation through the examination of 18 cases. We conducted a retrospective study of 14 patients with total or subtotal fingers amputation between June 2013 and January 2015. All unidigital and multidigital replantations downstream of the distal insertion of superficial flexor tendon as well as all digital replantations upstream of the distal insertion of superficial flexor tendon were included in our study...
2016: Pan African Medical Journal
https://www.readbyqxmd.com/read/27762620/reinforcement-of-the-flexor-tendon-repair-using-human-amniotic-membranea-biomechanical-evaluation-using-the-modified-kessler-method-of-tendon-repair
#15
Yunus Dogramaci, Ibrahim Gökhan Duman
BACKGROUND: Human amniotic membrane is used to prevent peritendinous adhesions after tendon injuries. This study compares the mechanical properties of modified Kessler repairs and modified Kessler repairs strengthened using multiple layers of human amniotic membrane. METHODS: Twenty flexor digitorum profundus tendons of sheep forelimbs were sutured by the two-strand modified Kessler technique (group A) and by the two-strand modified Kessler repair reinforced with multiple layers of human amniotic membrane (group B)...
September 2, 2016: Journal of the American Podiatric Medical Association
https://www.readbyqxmd.com/read/27746496/reconstruction-of-kuwada-grade-iv-chronic-achilles-tendon-rupture-by-minimally-invasive-technique
#16
Xudong Miao, Yongping Wu, Huimin Tao, Disheng Yang, Lu Huang
BACKGROUND: Transfer of a flexor hallucis longus (FHL) tendon can not only reconstruct the Achilles tendon but also provide ischemic tendinous tissues with a rich blood supply to enhance wound healing. This retrospective study aims to investigate clinical outcomes in patients who underwent repair of Kuwada grade IV chronic Achilles tendon rupture with long hallucis longus tendons harvested using a minimally invasive technique. MATERIALS AND METHODS: 35 patients who were treated for Kuwada grade IV Achilles tendon injuries from July 2006 to June 2011 were included in this retrospective study...
September 2016: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/27726447/exposure-of-a-tendon-extracellular-matrix-to-synovial-fluid-triggers-endogenous-and-engrafted-cell-death-a-mechanism-for-failed-healing-of-intrathecal-tendon-injuries
#17
Elaine R Garvican, Mazdak Salavati, Roger K W Smith, Jayesh Dudhia
AIM: The purpose of this study was to investigate the effect of normal synovial fluid (SF) on exposed endogenous tendon-derived cells (TDCs) and engrafted mesenchymal stem cells (MSCs) within the tendon extracellular matrix. METHODS: Explants from equine superficial digital flexor (extra-synovial) and deep digital flexor tendons (DDFTs) from the compressed, intra-synovial and the tensile, extra-synovial regions were cultured in allogeneic or autologous SF-media...
October 11, 2016: Connective Tissue Research
https://www.readbyqxmd.com/read/27711967/augmented-repair-of-an-achilles-tendon-rupture-using-the-flexor-digitorum-lateralis-tendon-in-a-toy-poodle
#18
Masaaki Katayama
OBJECTIVE: To report appositional augmentation of Achilles tendon rupture in a toy breed dog with an intact flexor digitorum lateralis (FDL) muscle tendon. STUDY DESIGN: Clinical case report. ANIMALS: Two-year-old spayed female Toy Poodle with Achilles tendon rupture. METHODS: The Achilles tendon was accidentally ruptured by hair clippers during grooming. The dog demonstrated a plantigrade stance without digital flexion of the right hind limb...
October 6, 2016: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/27692801/risk-of-prolonged-opioid-use-among-opioid-na%C3%A3-ve-patients-following-common-hand-surgery-procedures
#19
Shepard P Johnson, Kevin C Chung, Lin Zhong, Melissa J Shauver, Michael J Engelsbe, Chad Brummett, Jennifer F Waljee
PURPOSE: To evaluate prolonged opioid use in opioid-naïve patients after common hand surgery procedures in the United States. METHODS: We studied insurance claims from the Truven MarketScan databases to identify opioid-naïve adult patients (no opioid exposure 11 months before the perioperative period) who underwent an elective (carpal tunnel release, carpometacarpal arthroplasty/arthrodesis, cubital tunnel release, or trigger finger release) or trauma-related (closed distal radius fracture fixation, flexor tendon repair, metacarpal fracture fixation, or phalangeal fracture fixation) hand surgery procedure between 2010 and 2012 (N = 77,573 patients)...
September 7, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27684281/murine-flexor-tendon-injury-and-repair-surgery
#20
Jessica E Ackerman, Alayna E Loiselle
Tendon connects skeletal muscle and bone, facilitating movement of nearly the entire body. In the hand, flexor tendons (FTs) enable flexion of the fingers and general hand function. Injuries to the FTs are common, and satisfactory healing is often impaired due to excess scar tissue and adhesions between the tendon and surrounding tissue. However, little is known about the molecular and cellular components of FT repair. To that end, a murine model of FT repair that recapitulates many aspects of healing in humans, including impaired range of motion and decreased mechanical properties, has been developed and previously described...
2016: Journal of Visualized Experiments: JoVE
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