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Flexor tendon repair

Laurent Willemot, Filip R Hendrikx, Ann-Maria Byrne, Roger P van Riet
There has been an increase in thrower-specific elbow injuries in recent years. High valgus stresses during the late cocking and acceleration phases of throwing need to be compensated by the flexor pronator muscles as these can exceed the tensile strength of the medial collateral ligament complex. Prevention of injuries is the priority, with a focus on strengthening, reducing throwing frequency, decreasing force, and promoting a technique. The spectrum of thrower injuries ranges from a simple sprain to complete failure of the valgus stabilizing factors...
2018: Obere Extremität
Paweł Reichert, Aleksandra Królikowska, Maciej Kentel, Jarosław Witkowski, Jan Gnus, Wojciech Satora, Andrzej Czamara
PURPOSE: The studies comparing the fixation methods being used for the ruptured distal biceps brachii tendon reinsertion show similar outcomes of cortical button and suture anchors usage, however, longer follow-up studies remain necessary. The goal of this study was to compare the clinical and functional three-year outcomes of the cortical button in contrast to the suture anchor fixation. METHODS: A retrospective cohort study comprised of 28 males on average 3 years after surgical reinsertion of the distal biceps brachii tendon with the use of a cortical button (Group I, n = 11) or a suture anchor (Group II, n = 17)...
September 12, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Young-Keun Lee, Malrey Lee
RATIONALE: Spontaneous flexor pollicis longus (FPL) tendon rupture is rarely reported. Although there are several studies investigating spontaneous FPL tendon rupture, the exact etiology of spontaneous rupture is unclear. Here, we present a case of unusual spontaneous FPL tendon rupture due to tendolipomatosis. PATIENT CONCERNS: A 64-year-old right-handed retired male teacher was referred to our clinic with an inability to flex the interphalangeal joint of his left thumb...
September 2018: Medicine (Baltimore)
Jack G Graham, Mark L Wang, Michael Rivlin, Pedro K Beredjiklian
Tendon injuries of the hand that require surgical repair often heal with excess scarring and adhesions to adjacent tissues. This can compromise the natural gliding mechanics of the flexor tendons in particular, which operate within a fibro-osseous tunnel system similar to a set of pulleys. Even combining the finest suture repair techniques with optimal hand therapy protocols cannot ensure predictable restoration of hand function in these cases. To date, the majority of research regarding tendon injuries has revolved around the mechanical aspects of the surgical repair (i...
September 7, 2018: Connective Tissue Research
Teemu Karjalainen, Kaisa Jokinen, Sandeep J Sebastin, Toni Luokkala, Olli-Pekka Kangasniemi, Aleksi Reito
PURPOSE: Any loss of range of motion of the finger after flexor tendon repair is an impairment of function, but to what extent it causes disability is not properly understood. The aim of this study was to assess the correlation between perceived function (disability) and objectively measured loss of function (impairment), to understand what impairments are meaningful to patients. METHODS: We assessed 49 patients who underwent flexor tendon repair an average of 38 months after repair...
August 13, 2018: Journal of Hand Surgery
Alireza Yousefi, Farshid Sarrafzadeh-Rezaei, Siamak Asri-Rezaei, Amir-Abbas Farshid, Mehdi Behfar
Chitosan bears numerous properties, such as biocompatibility, biodegradability and non-toxicity making it suitable for use in different biomedical fields. Zinc (Zn) is required for fibroblasts proliferation and collagen synthesis as essential elements of wound healing. Its nanoparticles are well known for their capability to enhance wound healing by cell adhesion and migration improvement through growth factors-mediated mechanisms. Poor blood supply and unique histological characteristics of tendon make its regeneration always slow...
2018: Veterinary Research Forum
Bernd Hohendorff, C Knappwerth, J Franke, L P Müller, C Ries
INTRODUCTION: Stable pronator quadratus repair following volar plate fixation of distal radius fractures with complete plate coverage is difficult. MATERIALS AND METHODS: This study compares a modified pronator quadratus repair technique involving the brachioradialis muscle insertion (test group) with a conventional radial incision through the muscle without pronator quadratus repair (standard group). This prospective randomised study included 16 patients in the test group and 12 in the standard group; all were available for clinical, radiographic and ultrasound examination at a mean follow-up of 15 months...
October 2018: Archives of Orthopaedic and Trauma Surgery
Hua Shen, Rohith Jayaram, Susumu Yoneda, Stephen W Linderman, Shelly E Sakiyama-Elbert, Younan Xia, Richard H Gelberman, Stavros Thomopoulos
Intrasynovial tendon injuries are among the most challenging in orthopedics. Despite significant improvements in operative and rehabilitation methods, functional outcomes continue to be limited by adhesions, gap formation, and rupture. Adhesions result from excessive inflammation, whereas tendon gapping and rupture result from inflammation-induced matrix degradation and insufficient regeneration. Therefore, this study used a combined treatment approach to modulate inflammation with adipose-derived mesenchymal stromal cells (ASCs) while stimulating tendon regeneration with connective tissue growth factor (CTGF)...
July 23, 2018: Scientific Reports
Richard M Hinds, Nicole Montero-Lopez, Kenneth Brock, Ronald Adler, Anthony Sapienza, John T Capo, Nader Paksima
BACKGROUND: Previous work evaluating the pronator quadratus (PQ) muscle following volar plate fixation (VPF) of distal radius fractures (DRF) suggests that PQ repair often fails in the postoperative period. The purpose of this investigation was to assess PQ repair integrity following VPF of DRF using dynamic musculoskeletal ultrasonography. METHODS: Twenty adult patients who underwent VPF of DRF with repair of the PQ with a minimum follow-up of 3 months underwent bilateral dynamic wrist ultrasonography...
July 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
Sara Edsfeldt, Martin Eklund, Monica Wiig
STUDY DESIGN: Observational cohort study. INTRODUCTION: Investigating prognostic factors using population-based data may be used to improve functional outcome after flexor tendon injury and repair. PURPOSE OF THE STUDY: The aim of this study is to investigate the effect of concomitant nerve transection, combined flexor digitorum profundus (FDP) and flexor digitorum superficialis (FDS) tendon transection and the age of the patient, on digital range of motion (ROM) more than 1 year after FDP tendon transection and repair in zone I and II...
July 5, 2018: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
Gabriel Halát, Lukas L Negrin, Ewald Unger, Thomas Koch, Johannes Streicher, Jochen Erhart, Patrick Platzer, Stefan Hajdu
The purpose of this study was to determine the biomechanical characteristics of an innovative surgical technique based on a tension banding principle using a suture anchor in the repair of bony avulsions of the flexor digitorum profundus tendon. After injury simulation in 45 fresh frozen distal phalanges from human cadavers, repair was performed with minifragment screws, interosseous sutures and the innovative technique (15 per group). All repairs were loaded for a total of 500 cycles. Subsequently the specimens were loaded to failure...
July 2, 2018: Scientific Reports
Nikolaos Anastasopoulos, George Paraskevas, Nikolaos Lazaridis, Konstantinos Natsis
Isolated rupture of the flexor hallucis longus tendon is an unusual injury. We present the case of a neglected flexor hallucis longus tendon closed traumatic rupture at the plantar aspect of the first phalangeal head of the great toe in a middle-age male. The injury occurred while he was dancing. Because end-to-end tendon suture was impossible, the ensuing gap was repaired using a free plantaris tendon graft. We present the operative repair benefit of the flexor hallucis longus tendon rupture to regain the function and strength of the interphalangeal joint of the hallux, avoid extension of the distal phalanx, and maintain the longitudinal arch of the foot...
June 21, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
N Bigorre, F Delaquaize, F Degez, S Celerier
The repair of flexor tendon lesions in zone 2 remains a highly controversial subject in hand surgery. Currently, there is no consensus about the management of these lesions intra- and postoperatively, but the literature suggests that a solid suture will allow early active motion. We hypothesized that the management of flexor tendon injury in zone 2 varies widely. Two online surveys were conducted with surgeons and hand therapists. The questions captured the demographics of the surveyed population, surgical technique, common complications, postoperative management (duration of immobilization, type of splint, rehabilitation techniques and principles of self-rehabilitation)...
June 19, 2018: Hand Surgery and Rehabilitation
Jeremy Truntzer, Kevin Mertz, Sara Eppler, Kevin Li, Michael Gardner, Robin Kamal
BACKGROUND: In distal radius fracture repair, complications often lead to reoperation and increased cost. We examined the trends and complications in open reduction internal fixation of distal radius fractures across hand specialist and non-hand specialist surgeons. METHODS: We examined claims data from the Humana administrative claims database between 2007 and 2016. International Classification of Disease, 9th Edition and Current Procedural Terminology codes were searched related to distal radius fractures repaired by open reduction internal fixation...
June 19, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Mohammad R Khan, Jayesh Dudhia, Frederic H David, Roberta De Godoy, Vedika Mehra, Gillian Hughes, Stephanie G Dakin, Andrew J Carr, Allen E Goodship, Roger K W Smith
BACKGROUND: Intra-synovial tendon injuries display poor healing, which often results in reduced functionality and pain. A lack of effective therapeutic options has led to experimental approaches to augment natural tendon repair with autologous mesenchymal stem cells (MSCs) although the effects of the intra-synovial environment on the distribution, engraftment and functionality of implanted MSCs is not known. This study utilised a novel sheep model which, although in an anatomically different location, more accurately mimics the mechanical and synovial environment of the human rotator cuff, to determine the effects of intra-synovial implantation of MSCs...
June 19, 2018: Stem Cell Research & Therapy
Masato Ohara, Ryo Oda, Shogo Toyama, Yusei Katsuyama, Hiroyoshi Fujiwara, Toshikazu Kubo
INTRODUCTION: Closed flexor tendon rupture after a malunited distal radius fracture is rare and usually becomes apparent early after the fracture. Most cases are accompanied by a severe distal radio-ulnar joint capsule injury, wherein bone protrusion (as a spur) directly stresses the tendons. We experienced a nonspecific flexor tendon rupture associated with an old fracture and the presence of collagen disease. PRESENTATION OF CASE: A 63-year-old woman presented with delayed complete rupture of the flexor digitorum profundus (FDP) of the fifth digit...
2018: International Journal of Surgery Case Reports
Derek T Bernstein, Jamie J Alexander, Nancy J Petersen, Bradley S Lambert, Philip C Noble, David T Netscher
PURPOSE: To evaluate the impact of suture caliber and looped configurations on the integrity of 4-strand modified Kessler zone II flexor tendon repairs during progressive cyclic loading. METHODS: Seventy-two flexor digitorum profundus tendons from 18 fresh human cadaver hands were divided into 4 repair groups. Thirty-six matched tendons underwent repair using either a 4-0 looped or 4-0 single-stranded suture, and an additional 36 tendons underwent 3-0 looped or 3-0 single-stranded repairs...
June 8, 2018: Journal of Hand Surgery
James Williams, Rupert Wharton, Peter Peev, Maxim Horwitz
Delayed rupture of the extensor and flexor tendons are recognised complications of distal radius fractures. However, acute flexor tendon rupture in the context of forearm fractures is rare. A twelve-year-old female sustained midshaft fractures of the radius and ulna. Intra-operatively the flexor pollicis longus (FPL) was found to be stripped from its musculotendinous junction at the level of the fracture fragment. The ruptured tendon was repaired using a modified Krackow technique at the time of fracture fixation...
June 2018: Trauma Case Reports
Hai Li, Chengliang Deng, Zairong Wei, Wenhu Jin, Kaiyu Nie, Xiujun Tang, Dali Wang, Shusen Chang, Shujun Li
Objective: To evaluate the effectiveness of anterolateral thigh polyfoliate perforator flap plus pedicle with one foliate flap for repairing extremities soft tissue defect. Methods: Between January 2014 and January 2017, 24 patients with extremities soft tissue defects were treated by anterolateral thigh polyfoliate perforator flap plus pedicle with one foliate flap. There were 15 males and 9 females, with a median age of 33.5 years (range, 5-64 years). Wounds located in upper limb in 8 cases, complicated with radial styloid fracture in 1 case, extensor tendon exposure in 3 cases, and brachioradialis muscle tendon exposed in 1 case...
August 1, 2017: Chinese Journal of Reparative and Reconstructive Surgery
Yanqing Hu, Hai Jiang, Qi Li, Jian Li, Xin Tang
Objective: To evaluate the biomechanical property of tendons repaired with the modified Kessler suture combined with " 8" suture, and to provide evidence for the clinical application of this suture methods in repairing acute Achilles tendon rupture. Methods: Forty frozen flexor digitorum longus tendons from fresh pork hind leg were randomly assigned into 4 groups, 10 specimens each group. In group A, the tendons were dissected transversely at the midpoint to forming the model of tendon with transversely cutting injury...
October 1, 2017: Chinese Journal of Reparative and Reconstructive Surgery
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