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Flexor tendon repair

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https://www.readbyqxmd.com/read/28614277/the-pull-out-k-wire-anchorage-the-shepherd-s-crook-technique
#1
Daniele De Spirito, Dario Giunchi
Traditional pull-out techniques for tendon and ligament repair are still widely used in hand surgery, despite constant refinements and the development of other methods of fixation. We propose a modification of the classic technique which utilizes a K-wire as an external strut instead of the classic button. This fixation system can be usefully applied in the fixation of extensor and flexor tendons and reinsertions. It is particularly applicable in situations where a transarticular K-wire is to be used anyway, in situations of temporary joint immobilization and in other situations...
June 13, 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/28610452/outcomes-of-flexor-tendon-repairs-in-zone-2-subzones-with-early-active-mobilization
#2
K Moriya, T Yoshizu, N Tsubokawa, H Narisawa, S Matsuzawa, Y Maki
We report on the outcomes of flexor tendon repair in zone 2 subzones with early active mobilization in 102 fingers in 88 consecutive patients. There were 28, 53, 15, and six fingers with repairs in zones 2A to 2D, respectively. Rupture of the repair occurred in four fingers, all in zone 2B. Excluding those with repair ruptures, the mean total active motion was 230° (range 143°-286°). Evaluated with Tang's criteria, the outcomes were ranked excellent in 39 fingers, good in 46, fair in ten, poor in three, and failure in four...
June 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28604156/outcomes-of-repair-of-the-lacerated-a2-pulley-with-extensor-retinaculum-during-primary-flexor-tendon-repair
#3
A El-Shebly, M El Fahar, H Mohammed, A Bahaa Eldin
We report outcomes of repairing the lacerated A2 pulley with extensor retinaculum graft in ten patients (ten fingers) during primary flexor tendon repair in zone 2. Complete A2 pulley lacerations were found in eight fingers and partial A2 pulley laceration in two. We extended the laceration in the sheath to the middle of the A4 or A1 pulley to allow tendon repair with a four-strand core suture. The A2 pulley was reconstructed with an extensor retinaculum graft. All patients followed the early controlled active mobilization protocol and recovered active range of motion at the interphalangeal joints without major extension deficits...
June 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28583184/effect-of-single-intralesional-treatment-of-surgically-induced-equine-superficial-digital-flexor-tendon-core-lesions-with-adipose-derived-mesenchymal-stromal-cells-a-controlled-experimental-trial
#4
Florian Geburek, Florian Roggel, Hans T M van Schie, Andreas Beineke, Roberto Estrada, Kathrin Weber, Maren Hellige, Karl Rohn, Michael Jagodzinski, Bastian Welke, Christof Hurschler, Sabine Conrad, Thomas Skutella, Chris van de Lest, René van Weeren, Peter M Stadler
BACKGROUND: Adipose tissue is a promising source of mesenchymal stromal cells (MSCs) for the treatment of tendon disease. The goal of this study was to assess the effect of a single intralesional implantation of adipose tissue-derived mesenchymal stromal cells (AT-MSCs) on artificial lesions in equine superficial digital flexor tendons (SDFTs). METHODS: During this randomized, controlled, blinded experimental study, either autologous cultured AT-MSCs suspended in autologous inactivated serum (AT-MSC-serum) or autologous inactivated serum (serum) were injected intralesionally 2 weeks after surgical creation of centrally located SDFT lesions in both forelimbs of nine horses...
June 5, 2017: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28552932/biomechanical-properties-of-alternative-suture-technique-for-flexor-tendon-repair
#5
Tomasz Andrzejewski, Piotr Czarnecki, Mikołaj Dąbrowski, Robert Spławski, Piotr Rogala, Leszek Romanowski
PURPOSE: Flexor injuries are most common in the hand and require special attention and experience from the surgeon. Both quality and technique affect the stability of the suture. The selection of the optimum method will influence the process of rehabilitation. The aim of this study was to compare three different suture techniques based on the strength, depending on the method of breakage, i.e., axial or pulley load. METHODS: The study was divided into six sessions...
2017: Acta of Bioengineering and Biomechanics
https://www.readbyqxmd.com/read/28506172/the-effect-of-myostatin-gdf-8-on-proliferation-and-tenocyte-differentiation-of-rat-bone-marrow-derived-mesenchymal-stem-cells
#6
Wei Le, Jeffrey Yao
BACKGROUND: The future in flexor tendon surgery involves tissue engineering approaches directed toward increasing early repair strength to accelerate tendon healing and to allow for earlier onset of rehabilitation. Previous work has shown that pluripotential mesenchymal stem cells may be successfully delivered to a tendon repair site using a suture carrier. The current work describes the use of Myostatin (GDF-8) to help guide these delivered pluripotential stem cells to differentiate down a tenocyte lineage to potentially maximize the reparative effects of these cells at the tendon repair site...
June 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/28506161/symmetric-peripheral-running-sutures-are-superior-to-asymmetric-peripheral-running-sutures-for-increasing-the-tendon-strength-in-flexor-tendon-repair
#7
N Takeuchi, T Okada, N Kozono, T Shimoto, H Higaki, Y Iwamoto
BACKGROUND: The fatigue strength of three peripheral suture techniques for flexor tendon repair was compared by cyclic loading of the repairs in the porcine flexor digitorum tendon. METHODS: Thirty-six tendons were sutured using only peripheral sutures with 6-0 Nylon. An initial cyclic load of 10 N for 500 cycles was applied and increased by 10 N for an additional 500 cycles at each new load until rupture. RESULTS: The fatigue strength of the symmetric running peripheral suture was 85...
June 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/28501463/home-based-rehabilitation-in-the-postoperative-treatment-of-flexor-tendon-repair
#8
M Sanmartín-Fernández, B Fernández-Bran, J Couceiro-Otero
OBJECTIVE: To evaluate the results and complications of flexor tendon repair in which a home-based rehabilitation program was utilized without the assistance of a hand therapist during the first 4postoperative weeks. MATERIAL Y METHODS: Between July 2009 and July 2014, a total of 21 digits in 15 patients were treated in our institution for complete laceration of the flexor tendons within the flexor pulley system (zone 1 and 2). Passive and active exercises performed by the patients themselves were started the morning after the operation...
May 10, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/28501340/epitendinous-first-repair-of-zone-ii-flexor-digitorum-profundus-results-in-decreased-gliding-resistance
#9
Michael G Galvez, Garet C Comer, Arhana Chattopadhyay, Chao Long, Anthony W Behn, James Chang
PURPOSE: The importance of flexor tendon repair with both core and epitendinous suture placement has been well established. The objective of this study was to determine whether suture placement order affects gliding resistance and bunching in flexor digitorum profundus tendons in a human ex vivo model. METHODS: The flexor digitorum profundus tendons of the index, middle, ring, and little fingers of paired cadaver forearms were tested intact for excursion and mean gliding resistance in flexion and extension across the A2 pulley...
May 11, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28488452/biomechanical-investigation-of-uneven-load-bearing-in-six-strand-lim-tsai-flexor-tendon-repair-using-fiberloop-%C3%A2
#10
R A S Hay, Y R Wong, A M Loke, S C Tay
We hypothesized that, in providing biomechanical strength, at least one of the two middle strands in a modified six-strand Lim-Tsai flexor tendon repair could be divided without obvious reduction in repair strength owing to uneven load bearing. A total of 40 porcine flexor digitorum profundus tendons were repaired using the six-strand Lim-Tsai technique with a 4-0 FiberLoop(®) suture and then divided into four equal groups. (no cut, one middle strand cut, both middle strand cut, one side strand cut). The biomechanical performance of repaired tendons was tested and found to vary according to the location of the cuts...
June 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28476400/postoperative-repeat-dislocation-of-the-posterior-tibial-tendon-a-case-report
#11
Yasunari Ikuta, Nobuo Adachi, Tomoyuki Nakasa, Mitsuo Ochi
Dislocation of the posterior tibial tendon is an uncommon condition. Although surgery is usually performed in most cases of posterior tibial tendon dislocation, postoperative repeat dislocation of the posterior tibial tendon has not been reported in the published data. We report the case of a 27-year-old male patient who experienced repeat dislocation of the posterior tibial tendon after a gymnastic landing, 44 months after initial retinaculum repair. For revision surgery, we reconstructed the flexor retinaculum in conjunction with deepening of the retromalleolar groove, because the groove was hypoplastic...
May 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28467577/evaluation-of-forearm-arterial-repairs-functional-outcomes-related-to-arterial-repair
#12
Musa Kemal Keleş, Tekin Şimşek, Veysel Polat, Engin Yosma, Ahmet Demir
BACKGROUND: There are few studies of single forearm arterial injury repair that compare long-term results of intact and obliterated forearm arterial repair. Aim of the present study was to compare long-term results of forearm arterial repair using Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) score and color Doppler ultrasound (CDUS). METHODS: Records of 166 consecutive patients with forearm arterial injury were reviewed, and 30 patients with same injury (ulnar artery, ulnar nerve, and tendon injuries at flexor zone V) were called back for CDUS and QuickDASH scoring...
March 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28462460/combined-administration-of-ascs-and-bmp-12-promotes-an-m2-macrophage-phenotype-and-enhances-tendon-healing
#13
Richard H Gelberman, Stephen W Linderman, Rohith Jayaram, Anna D Dikina, Shelly Sakiyama-Elbert, Eben Alsberg, Stavros Thomopoulos, Hua Shen
BACKGROUND: Outcomes after intrasynovial tendon repair are highly variable. An intense inflammatory cascade followed by a delayed healing response can cause adhesion formation and repair-site failure that severely impair the function of repaired digits. No effective remedies exist to fully address these issues. Cell- and growth factor-based therapies have been shown to modulate inflammation and improve cell proliferation and matrix synthesis and therefore are promising treatment approaches for intrasynovial tendon repair...
May 1, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28453343/acute-isolated-flexor-tendon-laceration-associated-with-a-distal-radius-fracture
#14
J Ryan Hill, Ram K Alluri, Alidad Ghiassi
BACKGROUND: Subacute rupture of the flexor tendons secondary to distal radius fractures is well documented. Recently, accounts of flexor tendon rupture following open reduction internal fixation have been associated with volar plate fixation. However, discovery of an occult traumatic flexor tendon laceration during fixation of an acute distal radius fracture is not well described. This case indicates the importance of careful preoperative and intraoperative examination of the flexor tendons in the setting of comminuted distal radius fractures...
May 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28442075/passive-stiffness-of-the-ankle-and-plantar-flexor-muscle-performance-after-achilles-tendon-repair-a-cross-sectional-study
#15
Pollyana R T Borges, Thiago R T Santos, Paula R S Procópio, Jessica H D Chelidonopoulos, Roberto Zambelli, Juliana M Ocarino
BACKGROUND: Deficits in ankle muscle strength and ankle stiffness may be present in those subjects who underwent surgical treatment for an Achilles tendon rupture. The presence of these long-term deficits may contribute to a lower performance during daily activities and may be linked to future injuries. OBJECTIVE: To compare the ankle passive stiffness and the plantar flexor muscle performance in patients who underwent unilateral surgical treatment of Achilles tendon rupture with nonsurgical subjects...
January 2017: Brazilian Journal of Physical Therapy
https://www.readbyqxmd.com/read/28423932/comparing-biomechanical-properties-repair-times-and-value-of-common-core-flexor-tendon-repairs
#16
Aakash Chauhan, Patrick Schimoler, Mark C Miller, Alexander Kharlamov, Gregory A Merrell, Bradley A Palmer
BACKGROUND: The aim of the study was to compare biomechanical strength, repair times, and repair values for zone II core flexor tendon repairs. METHODS: A total of 75 fresh-frozen human cadaveric flexor tendons were harvested from the index through small finger and randomized into one of 5 repair groups: 4-stranded cross-stitch cruciate (4-0 polyester and 4-0 braided suture), 4-stranded double Pennington (2-0 knotless barbed suture), 4-stranded Pennington (4-0 double-stranded braided suture), and 6-stranded modified Lim-Tsai (4-0 looped braided suture)...
April 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28419543/aging-does-not-alter-tendon-mechanical-properties-during-homeostasis-but-does-impair-flexor-tendon-healing
#17
Jessica E Ackerman, Ibrahima Bah, Jennifer H Jonason, Mark R Buckley, Alayna E Loiselle
Aging is an important factor in disrupted homeostasis of many tissues. While an increased incidence of tendinopathy and tendon rupture are observed with aging, it is unclear whether this is due to progressive changes in tendon cell function and mechanics over time, or an impaired repair reaction from aged tendons in response to insult or injury. In the present study, we examined changes in the mechanical properties of Flexor Digitorum Longus (FDL), Flexor Carpi Ulnaris (FCU), and tail fascicles in both male and female C57Bl/6 mice between 3 and 27 months of age to better understand the effects of sex and age on tendon homeostasis...
April 17, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28399642/acute-tears-of-the-tibialis-posterior-tendon-following-ankle-sprain
#18
Lyle T Jackson, Linda J Dunaway, Gregory A Lundeen
BACKGROUND: Traumatic tears of the tibialis posterior (TP) tendon following an ankle sprain are rare. The purpose of this study was to report our case series of TP tendon tears following an ankle sprain. METHODS: Patients with persistent TP tendon pain after an ankle sprain were retrospectively identified over a 4-year period and reviewed. A comparison of magnetic resonance imaging (MRI) interpretations by a radiologist and surgeon was made. Patients failing conservative management underwent operative repair of the TP tendon tear and concomitant pathology...
April 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28370152/long-term-outcome-of-an-intra-articular-allograft-technique-for-treatment-of-spontaneous-cranial-cruciate-ligament-rupture-in-the-dog
#19
Jeffery J Biskup, Daniel G Balogh, Ruth M Scott, Michael G Conzemius
OBJECTIVE: To determine the 12-month outcome in dogs with spontaneous cranial cruciate ligament (CCL) rupture after repair with an intra-articular decellularized allograft. STUDY DESIGN: Prospective pilot case series. ANIMALS: Ten client-owned dogs with unilateral CCL rupture. METHODS: An intra-articular, decellularized, deep digital flexor tendon allograft was secured in the stifle with a femoral cross pin and tibial spiked washers and screws...
March 31, 2017: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/28365148/outcomes-after-flexor-tendon-repair-combined-with-the-application-of-human-amniotic-membrane-allograft
#20
Olli V Leppänen, Teemu Karjalainen, Harry Göransson, Annika Hakamäki, Jouni Havulinna, Jyrki Parkkinen, Jarkko Jokihaara
PURPOSE: Clinically proven methods to prevent adhesion formation after flexor tendon repair have not yet been established. The aim of this pilot study was to assess the feasibility of amniotic membrane allograft as a mechanical barrier to decrease adhesion formation. METHODS: Ten patients having flexor tendon injuries were planned to be recruited to the pilot study. The operative treatment consisted of tendon repair and fixation of amniotic membrane allograft around the repaired tendon...
March 29, 2017: Journal of Hand Surgery
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