Triggering After Partial Tendon Laceration

1993 ◽  
Vol 18 (2) ◽  
pp. 241-246 ◽  
Author(s):  
M. M. AL-QATTAN ◽  
J. C. POSNICK ◽  
K. Y. LIN

Triggering and tendon flap formation were studied after a transverse laceration of 50% of the width of the flexor digitorum profundus tendons of the hind limb of 14 adult sheep at various intervals after injury. The tendon laceration was not repaired and there was no post-operative immobilization. Triggering was not caused by bulbous scar formation but by the bunching of the tendon fibres proximal or distal to the laceration site. This bunched part of the tendon appeared to become incorporated into the healing process, with gradual spontaneous resolution of triggering. Failure of incorporation of this bunched part resulted in the formation of a flap in two tendons.

2010 ◽  
Vol 36 (2) ◽  
pp. 147-153 ◽  
Author(s):  
M. M. Al-Qattan

The ‘figure of eight’ suture technique for flexor tendon repair is known to be simple and strong but it has the major disadvantage of being bulky, with the knots outside the repair site. When the superficialis tendon is intact it may cause impingement and/or increase the work of flexion with postoperative mobilization and it is not known whether this bulky repair is suitable for isolated profundus injuries in zone II. A series of 36 patients (36 fingers) with clean-cut isolated flexor digitorum profundus tendon injuries in zones IIA/IIB were reviewed retrospectively. Repairs were done with three ‘figure of eight’ sutures and the pulleys proximal to the tendon laceration level were vented. Postoperatively, early active exercises were carried out. There were no ruptures. At a mean final follow-up of 6 months, the outcome (in range of motion) was excellent in 27 fingers and good in the remaining nine fingers by the Strickland criteria. It was concluded that the bulky ‘figure of eight’ technique can be used in isolated profundus tendon injuries in zones IIA/IIB.


2013 ◽  
Vol 7 (1) ◽  
pp. 282-285 ◽  
Author(s):  
Jun Sasaki ◽  
Toshiro Itsubo ◽  
Koichi Nakamura ◽  
Masanori Hayashi ◽  
Shigeharu Uchiyama ◽  
...  

We present the case of a patient with flexor digitorum profundus tendon laceration at the A2 pulley level caused by an injury to the base of the right ring finger by a knife. The patient was treated by flexor tendon reconstruction from the palm to the fingertip by using the left second toe flexor tendon as a graft, which improved the active range of motion. Further improvement was achieved by subsequent tenolysis, which eventually restored nearly normal function. Our experience with this case indicates that the intrasynovial tendon is a reasonable graft source for the synovial space in fingers and may enable restoration of excellent postoperative function.


Hand ◽  
2016 ◽  
Vol 12 (5) ◽  
pp. NP92-NP94
Author(s):  
Shane R. Jackson ◽  
Meily Tan ◽  
Kim O. Taylor

Background: Trigger finger is a common condition, causing impaired gliding of the digital flexor tendons. Chronic inflammation is the usual cause, but acute trigger finger following partial tendon laceration has also been described. Methods: We describe the case of a four year old girl who presented with inability to flex her index finger. Operative exploration revealed a closed partial rupture of the flexor digitorum profundus tendon, catching on the A2 pulley and preventing normal tendon gliding. Results: Excision of the damaged section of tendon allowed normal gliding motion, and once the wound had healed the patient regained full painless motion. Conclusion: Acute trigger finger caused by partial flexor tendon injury is an uncommon but well-documented presentation. Surgical exploration not only confirms the diagnosis, but allows for excision of the damaged segment to return normal movement without compromising strength.


1995 ◽  
Vol 20 (3) ◽  
pp. 314-318 ◽  
Author(s):  
M. M. AL-QATTAN ◽  
J. C. POSNICK ◽  
K. Y. LIN

The in vivo response of foetal flexor digitorum profundus tendons to tendon sutures was studied macroscopically and microscopically in foetal lambs. No tendon adhesions were noted at any of the examination intervals. 4 days after injury, a mild inflammatory reaction was noted around the suture. The tendon examined at the 4-week interval showed evidence of migration of epitenon cells from the outer surface of the tendon into the suture track. The tendon examined at the 6-week interval showed normal tendon fibres surrounding the suture site. Differences between foetal skin and foetal tendon healing are discussed along with the possible role of amniotic fluid in modulating the healing process in the foetus.


Cases Journal ◽  
2009 ◽  
Vol 2 (1) ◽  
pp. 9319 ◽  
Author(s):  
Dimitrios Giannikas ◽  
Efstratios Athanaselis ◽  
Charalambos Matzaroglou ◽  
Alkis Saridis ◽  
Minos Tyllianakis

1992 ◽  
Vol 17 (5) ◽  
pp. 561-568 ◽  
Author(s):  
J. P. NESSLER ◽  
P. C. AMADIO ◽  
L. J. BERGLUND ◽  
K.-N. AN

The effect of external force environment on the healing of a partial thickness injury to canine flexor tendon was studied. A 50% laceration was made in either the fibrocartilaginous (compressive) zone or in the tendinous (tensile) zone of canine flexor digitorum profundus tendons. After three or six weeks, the tendons were harvested. An optical method for determining zone-specific material properties showed that, in response to injury, the structural stiffness decreased in the tensile zone of the tendon but increased in the compressive zone. The mechanical properties and failure mechanism of canine tendon and their changes in response to injury vary according to tendon zone, and differences in the healing process in mechanically specialised zones of the flexor tendon are discussed.


2021 ◽  
Vol 7 ◽  
pp. 205951312110292 ◽  
Author(s):  
Sarah O’Reilly ◽  
Erin Crofton ◽  
Jason Brown ◽  
Jennifer Strong ◽  
Jenny Ziviani

Introduction: Tapes have been used to aid fresh wound closure. For hypertrophic scars, the use of tapes as a therapy to reduce the mechanical forces that stimulate excessive and long-term scarring is yet to be evaluated. The aim of this comprehensive review was to explore the current clinical application of tapes, as a minimally invasive option, as purposed specifically for the management of hypertrophic scarring, regardless of scar causation. Method: Databases were searched using MeSH terms including one identifier for hypertrophic scar and one for the intervention of taping. Studies included the following: patients who received tape for a minimum of 12 weeks as a method of wound closure specifically for the purpose of scar prevention; those who received tape as a method of scar management after scar formation; reported outcomes addressing subjective and/or objective scar appearance; and were available in English. Results: With respect to non-stretch tapes, their use for the prevention of linear surgical scarring is evident in reducing scar characteristics of height, colour and itch. Statistically significant results were found in median scar width, reduction in procedure times and overall scar rating. Tapes were predominately applied by participants themselves, and incidence of irritation was infrequently reported. After 12 months, significance with respect to scar pain, itch, thickness and overall scar elevation was reported in one study investigating paper tape. Two papers reported the use of high stretch tapes; however, subjective results limited formal analysis. Although the use of taping for abnormal hypertrophic scar management is in its infancy, emerging research indicates tapes with an element of stretch may have a positive impact. Conclusions: Non-stretch tapes, for the prevention of linear surgical scarring, are effective in reducing scar characteristics of height, colour and itch. Paper tapes have shown effectiveness when applied during wound remodelling or even on mature scarring, with reported subjective changes in scar colour, thickness and pliability. Preliminary evidence of the benefits of high-stretch, elasticised tapes for scar management in the remodelling phase of wound healing have also been reported. Lay Summary Patients are often concerned about unsightly scars that form on their bodies after trauma, especially burn injuries. These scars can be thick, red and raised on the skin, and can impact on the patient’s quality of life. For some scars, the process of skin thickening continues for up to two years after an injury. Unfortunately, scar formation is a part of the body’s healing process, whereby there is a constant pull or tension under and along the skin’s surface. The use of simple tapes, such as microporetm, to help with wound closure are sometimes used as a therapy to reduce the tension on the skin’s surface when a wound is healing to minimise scar formation. However, the effectiveness of taping has not been proven. This paper looks at the available evidence to support the use of taping to reduce scar features of height, thickness and colour. Initial evidence of mixed levels, suggests some benefits of tapes for scar management and show preliminary efficacy for reduction of scar height, thickness and colour. More research is required to determine the direct impact, comparison to other treatments available and patient viewpoint for this therapy.


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