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Flexor tendon repair

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
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
E R Garvican, M Salavati, R K W Smith, J Dudhia
AIM: The purpose of this study was to investigate the effect of normal synovial fluid (SF) on exposed endogenous tendon-derived cells (TDC) 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 (DDFT) from the compressed, intra-synovial and the tensile, extra-synovial regions were cultured in allogeneic or autologous SF-media. Human hamstring explants were cultured in allogeneic SF...
October 11, 2016: Connective Tissue Research
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
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
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
J Fan, B Jiang, B Wang, K Chen, F Yuang, J Mei, G-R Yu
The aim of the study was to analysis soft-tissue complications of volar plate fixation and it's prevention strategies along with exploring clinical effects of preserving pronator quadratus (PQ) muscle. From February 2011 to February 2013, sixty-five patients with distal radius fracture underwent open reduction and internal fixation with the volar locking palmar plates. The group with preserving PQ involved 30 patients and group with PQ repair involved 35 patients. Surgeons must took great care of not -letting drill pierce dorsal cortical bone rapidly and dorsal carpal tangential fluoroscopy was also taken in addition to lateral fluoroscopy to get accurate screw length...
August 2016: Acta Orthopaedica Belgica
Hua Shen, Ioannis Kormpakis, Necat Havlioglu, Stephen W Linderman, Shelly E Sakiyama-Elbert, Isaac E Erickson, Thomas Zarembinski, Matthew J Silva, Richard H Gelberman, Stavros Thomopoulos
BACKGROUND: The clinical outcomes following intrasynovial flexor tendon repair are highly variable. Excessive inflammation is a principal factor underlying the formation of adhesions at the repair surface and affecting matrix regeneration at the repair center that limit tendon excursion and impair tendon healing. A previous in-vitro study revealed that adipose-derived mesenchymal stromal cells (ASCs) modulate tendon fibroblast response to macrophage-induced inflammation. The goal of the current study was therefore to explore the effectiveness of autologous ASCs on the inflammatory stage of intrasynovial tendon healing in vivo using a clinically relevant animal model...
September 27, 2016: Stem Cell Research & Therapy
Jin Yong Shin, Jin Soo Kim, Si-Gyun Roh, Nae-Ho Lee, Kyung-Moo Yang
BACKGROUND: The barbed suture technique uses newly developed materials for flexor tendon repair. In this study, the authors examine the effectiveness of using barbed sutures in flexor tendon repair compared with conventional methods. METHODS: A systematic literature review and meta-analysis was performed using MEDLINE, Embase, and Cochrane databases. Barbed suture and conventional suture methods were extracted as predictor variables, and maximum force, gap formation force, and cross-sectional area were extracted as outcome variables...
October 2016: Plastic and Reconstructive Surgery
Sara Edsfeldt, Björn Holm, Margit Mahlapuu, Carol Reno, David A Hart, Monica Wiig
PURPOSE: To investigate the anti-adhesive mechanisms of PXL01 in sodium hyaluronate (HA) by using the rabbit lactoferrin peptide, rabPXL01 in HA, in a rabbit model of healing tendons and tendon sheaths. The mechanism of action for PXL01 in HA is interesting since a recent clinical study of the human lactoferrin peptide PXL01 in HA administered around repaired tendons in the hand showed improved digit mobility. MATERIALS AND METHODS: On days 1, 3, and 6 after tendon injury and surgical repair, reverse transcriptase-quantitative polymerase chain reaction (RT-qPCR) was used to assess mRNA expression levels for genes encoding the mucinous glycoprotein PRG4 (also called lubricin) and a subset of matrix proteins, cytokines, and growth factors involved in flexor tendon repair...
September 23, 2016: Upsala Journal of Medical Sciences
Stefan Hartwig, Christian Doll, Jan Oliver Voss, Moritz Hertel, Saskia Preissner, Jan Dirk Raguse
PURPOSE: The treatment of wound healing disturbances of the radial forearm free flap donor site after reconstructive surgery is typically long and burdensome and often requires additional surgery. Cold atmospheric plasma is a promising approach to overcome these impairments. The aim of this proof of concept study was to evaluate the clinical outcome of plasma irradiation in patients with wound healing disorders with exposed brachial tendons of the radial forearm. PATIENTS AND METHODS: Four patients (mean age 64...
August 24, 2016: Journal of Oral and Maxillofacial Surgery
Gabriella Meier Bürgisser, Maurizio Calcagni, Elias Bachmann, Gion Fessel, Jess G Snedeker, Pietro Giovanoli, Johanna Buschmann
After tendon rupture repair, two main problems may occur: re-rupture and adhesion formation. Suitable non-murine animal models are needed to study the healing tendon in terms of biomechanical properties and extent of adhesion formation. In this study 24 New Zealand White rabbits received a full transection of the Achilles tendon 2 cm above the calcaneus, sutured with a 4-strand Becker suture. Post-surgical analysis was performed at 3, 6 and 12 weeks. In the 6-week group, animals received a cast either in a 180 deg stretched position during 6 weeks (adhesion provoking immobilization), or were re-casted with a 150 deg position after 3 weeks (adhesion inhibiting immobilization), while in the other groups (3 and 12 weeks) a 180 deg position cast was applied for 3 weeks...
September 15, 2016: Biology Open
Ilgin Sade, Murat İnanir, Suzan Şen, Esra Çakmak, Serkan Kablanoğlu, Barin Selçuk, Nigar Dursun
[Purpose] The primary aim of this study was to assess rehabilitation outcomes for early and two-stage repair of hand flexor tendon injuries. The secondary purpose of this study was to compare the findings between treatment groups. [Subjects and Methods] Twenty-three patients were included in this study. Early repair (n=14) and two-stage repair (n=9) groups were included in a rehabilitation program that used hand splints. This retrospective evaluated patients according to their demographic characteristics, including age, gender, injured hand, dominant hand, cause of injury, zone of injury, number of affected fingers, and accompanying injuries...
August 2016: Journal of Physical Therapy Science
Shrikant J Chinchalkar, Juliana Larocerie-Salgado, Nina Suh
Despite the number of rehabilitation strategies and guidelines developed to maximize the gliding amplitude of repaired tendons, secondary complications, such as decreased range of motion and stiffness associated with tendon adhesions, commonly arise. If left untreated, these early complications may lead to secondary pathomechanical changes resulting in fixed deformities and decreased function. Therefore, an appropriate treatment regimen must not only include strategies to maintain the integrity of the repaired tendon, but must also avoid secondary complications due to reduced gliding amplitude...
August 2016: Journal of Hand and Microsurgery
Marshall A Kuremsky, Nahir Habet, Richard D Peindl, R Glenn Gaston
PURPOSE: To quantify the distance of the dorsal ulnar sensory branch, floor of the extensor carpi ulnaris (ECU) subsheath, and ulnar neurovascular bundles from the triangular fibrocartilage complex (TFCC), and secondarily to assess the safety of an all-inside arthroscopic repair of the TFCC with a commonly used meniscal repair device with respect to the aforementioned structures. METHODS: A custom K-wire with 1-mm gradation was used to determine the distance of at-risk structures from the periphery of the TFCC in 13 above-elbow human cadaver specimens...
September 7, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Eric M Padegimas, David M Beck, David I Pedowitz
: The authors present a case of a previously healthy and athletic 17-year-old female who presented with a 3.5-year history of medial left ankle pain after sustaining an inversion injury while playing basketball. Prior to presentation, she had failed prior immobilization and physical therapy for a presumed ankles sprain. Physical examination revealed a dislocated posterior tibial tendon (PTT) that was temporarily reducible, but would spontaneously dislocate immediately after reduction...
September 7, 2016: Foot & Ankle Specialist
Florian Geburek, Moritz Gaus, Hans T M van Schie, Karl Rohn, Peter M Stadler
BACKGROUND: Regenerative and anti-inflammatory effects on tendinopathies have been attributed to blood-derived biologicals. To date the evidence for the efficacy of autologous platelet-rich plasma (PRP) treatment of naturally occurring equine tendinopathies is limited. The purpose of this placebo-controlled clinical trial was to describe the effect of a single treatment of equine superficial digital flexor tendon (SDFT) disease with PRP on clinical and ultrasonographic parameters. Twenty horses with naturally occurring tendinopathies of forelimb SDFTs were randomly assigned to the PRP-treated group (n = 10) or control group (n = 10) after clinical and ultrasonographic examination...
2016: BMC Veterinary Research
Mikayla Southam, Susan Driessens, Christopher Burton, Rodney Pope, Penelope Thurnwald
STUDY DESIGN: Retrospective cohort study. INTRODUCTION: The QuickDASH outcome measure is a valid and reliable measurement tool for assessing disabilities of the arm, shoulder and hand. PURPOSE OF STUDY: There is limited literature providing typical QuickDASH scores for upper limb conditions. Therefore, the aim of this study was to determine the QuickDASH scores typically observed in specific upper limb pathologies. METHODS: This study examined QuickDASH scores for acute trauma conditions presenting for hand therapy...
September 2, 2016: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
Raakhi Mistry, Michael John McCleave, John Codrington
BACKGROUND: Flexor tendon repair failures have primarily been attributed to either core suture rupture or core suture pull out. Recent studies have suggested that knot unravelling may also cause failure of a tendon repair. The aim of this study was to investigate the causes of core suture failure in two types of common flexor tendon repairs. METHODS: Twenty four cadaver tendons were divided into three groups of eight. Each group tested a specific flexor tendon repair...
October 2016: J Hand Surg Asian Pac Vol
P Hahn, M C Kirchberger, F Unglaub, C K Spies
PURPOSE: Scores are essential for comparing function after flexor tendon reconstructions. The Buck-Gramcko Score, the Strickland Score and the ASSH (American Society for Surgery of the Hand) Score are the most commonly applied rating systems. The purpose of this study is to evaluate these systems and their interchangeability. METHOD: Based on an unrestricted metacarpophalangeal (MCP) joint of 0-0-90° or limited range of motion of the MCP joint of 0-30-90°, the scores of the 3 rating systems were assessed and graphically displayed for each possible finger position regarding proximal (PIP) and distal (DIP) interphalangeal joints...
August 2016: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
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