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Flexor tendon repair

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https://www.readbyqxmd.com/read/28205484/a-biomechanical-comparison-of-different-knots-tied-on-fibrewire-suture
#1
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
#2
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
#3
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...
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/28004174/altered-patterns-of-displacement-within-the-achilles-tendon-following-surgical-repair
#10
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
#11
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
#12
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
#13
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...
February 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27885382/mri-in-flexor-tendon-rupture-after-collagenase-injection
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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