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Flexor tendon repair

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https://www.readbyqxmd.com/read/29351182/the-management-of-partial-zone-ii-intrasynovial-flexor-tendon-lacerations-a-literature-review-of-biomechanics-clinical-outcomes-and-complications
#1
Kyle D Lineberry, Shirley Shue, Kyle J Chepla
BACKGROUND: Penetrating trauma or lacerations within zone II of the flexor sheath may result in partial tendon injury. The proper management of this injury is controversial; the literature contains differing indications for surgical treatment and post-operative rehabilitation. METHODS: A literature review of the Cochrane, Medline and Pubmed databases was performed using the following search criteria: partial, flexor, tendon, laceration. All English language studies that evaluated biomechanical strength, complications, and outcomes after partial tendon injury in human and animal studies were included and reviewed by two of the authors...
January 12, 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29303923/flexor-tendon-injuries
#2
Christopher S Klifto, John T Capo, Anthony Sapienza, S Steven Yang, Nader Paksima
Flexor tendon injuries of the hand are uncommon, and they are among the most challenging orthopaedic injuries to manage. Proper management is essential to ensure optimal outcomes. Consistent, successful management of flexor tendon injuries relies on understanding the anatomy, characteristics and repair of tendons in the different zones, potential complications, rehabilitation protocols, recent advances in treatment, and future directions, including tissue engineering and biologic modification of the repair site...
January 15, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29302136/in-vitro-comparison-of-two-barbed-suture-configurations-for-flexor-tendon-repair
#3
Jamie L Engel, Joseph N Gabra, Andrew R Esterle, William D Lanzinger, John J Elias
Purpose  The current study compares the strength of a previously studied technique for flexor tendon repair with barbed sutures to an experimental approach that aligns all the barbs to oppose distraction. Methods  Twelve flexor tendons from cadaveric specimens were mechanically tested following repair of simulated zone II tendon injuries. Two repair techniques utilizing barbed sutures were studied: the Marrero-Amadeo four-core barbed suture approach and the experimental configuration with all barbs on four cores opposing distraction...
December 2017: Journal of Hand and Microsurgery
https://www.readbyqxmd.com/read/29275614/-wound-repair-and-functional-reconstruction-of-high-voltage-electrical-burns-in-wrists
#4
Y M Shen, C X Ma, F J Qin, C Zhang, C Wang, X H Hu
Objective: To explore the methods and effects of wound repair and functional reconstruction of high-voltage electrical burns in wrists. Methods: From January 2009 to June 2016, 71 patients with high-voltage electrical burns in wrists were hospitalized, with 118 wrist wounds including 21 of type Ⅰ, 69 of type Ⅱ, 9 of type Ⅲ, and 19 of type Ⅳ. According to the wrist injuries, different surgical operations were performed. Forearm amputation was conducted in 20 wrists with necrosis in the distal end. On the basis of fasciotomy for decompression, early debridement was performed on the other 98 wrist wounds...
December 20, 2017: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/29248396/biomechanical-study-comparing-pulvertaft-suture-to-step-cut-suture
#5
A Duprat, L-E Gayet, C Breque, M Freslon
Tendon grafts are a component of the therapeutic arsenal for managing chronic flexor tendons injuries in the hand, especially during two-stage Hunter reconstruction. The purpose of this anatomical study was to compare the strength of the Pulvertaft weave versus the step-cut suture used for flexor tendon reconstruction to determine their role in early active mobilization. We performed a biomechanical study with cadaver specimens. Thirty-four hands were randomized and the tendons from both hands were equally assigned to each group...
December 13, 2017: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/29228408/-biomechanical-evaluation-of-rehabilitation-after-surgical-repair-of-achilles-tendon-ruptures
#6
Marlene Mauch, Markus Ulrich, Xaver Kaelin, Bernhard Segesser, Jochen Paul
Background Muscles and tendons are subjected to a high level of stress in everyday life and sports. This often leads to injuries and is associated with training failure and reduced performance as well as with high costs for treatment and rehabilitation. Fast and successful treatment is therefore very important, both from an athletic and economic point of view. This study aims to demonstrate the relevance of biomechanical procedures for the objective monitoring of rehabilitation. At the same time, the results are to be used to establish progress and evaluation criteria for an efficient and controlled rehabilitation...
December 2017: Sportverletzung Sportschaden: Organ der Gesellschaft Für Orthopädisch-Traumatologische Sportmedizin
https://www.readbyqxmd.com/read/29223409/obtaining-adequate-tension-for-extensor-hallucis-longus-tendon-rupture-repair-using-wide-awake-surgery-a-case-report
#7
Takenori Matsuda, Akira Taniguchi, Koji Hayashi, Yasuaki Nakanishi, Yasuhito Tanaka
Wide-awake surgery has potential advantages for treating extensor or flexor tendon injury. We present a case of chronic extensor hallucis longus injury treated with turn-down reconstruction using wide-awake surgery with a selective nerve block. To the best of our knowledge, this is the first such case reported. The patient had dropped a knife proximal to the right hallux metatarsophalangeal joint. Because direct suturing was thought to be difficult, turn-down reconstruction was performed under a selective nerve block...
December 7, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29218649/treatment-of-flexor-tendon-reconstruction-failures-multicentric-experience-with-brunelli-active-tendon-implant
#8
A Poggetti, M Novi, M Rosati, D Ciclamini, M Scaglione, B Battiston
INTRODUCTION: Secondary repair of flexor tendon injuries remain a challenging procedure for hand surgeons. Usually, secondary reconstruction should be performed by staged approach. When the tendon and pulley integrity are intact, tenolysis may be the first surgical option. One-/two-stage tendon grafts are suggested when the integrity of flexor tendon is compromised. Active tendon implants (Brunelli prostheses) may represent an efficient option in patients with a poor prognosis, as well as whenever classical techniques fail...
December 7, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29169630/kinetic-analysis-of-canine-gait-on-the-effect-of-failure-tendon-repair-and-tendon-graft
#9
Yu-Shiuan Cheng, Ramona Reisdorf, Alyssa Vrieze, Steven L Moran, Peter C Amadio, Kai-Nan An, Chunfeng Zhao
Kinetic analysis of canine gait has been extensively studied, including normal and abnormal gait. However, no research has looked into how flexor tendon injury and further treatment would affect the walking pattern comparing to the uninjured state. Therefore, this study was aimed to utilize a portable pressure walkway system, which has been commonly used for pedobarographic and kinetic analysis in the veterinary field, to examine the effect of a failed tendon repair and tendon graft reconstruction on canine digit kinetics during gait...
November 20, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/29166314/step-cut-lengthening-a-technique-for-treatment-of-flexor-pollicis-longus-tendon-rupture
#10
Chew-Wei Chong, Shih-Heng Chen
Reconstruction of a tendon defect is a challenging task in hand surgery. Delayed repair of a ruptured flexor pollicis longus (FPL) tendon is often associated with tendon defect. Primary repair of the tendon is often not possible, particularly after debridement of the unhealthy segment of the tendon. As such, various surgical treatments have been described in the literature, including single-stage tendon grafting, 2-stage tendon grafting, flexor digitorum superficialis tendon transfer from ring finger, and interphalangeal joint arthrodesis...
November 21, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29145347/fingertip-winding-suture-pull-out-suture-technique-for-flexor-tendon-repair-in-zone-i
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
COMPARATIVE STUDY
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
#18
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
#19
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
#20
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 Journal of Anesthesiology
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