A New Approach to Flexor Tendon Repair

1994 ◽  
Vol 19 (4) ◽  
pp. 513-516 ◽  
Author(s):  
P. P. CALLAN ◽  
W. A. MORRISON

This paper describes a new and simple approach to the flexor tendon via strategically placed transverse incisions in the flexor tendon sheath.

HAND ◽  
1977 ◽  
Vol os-9 (2) ◽  
pp. 143-146
Author(s):  
A. R. Moscona ◽  
R. Sekel ◽  
E. R. Owen

Twenty-five fingers of seven monkeys were used for an experimental study of a new concept of flexor tendon repair in “No Man's Land”. Microsurgical aids were used to shift distally a sleeve of healthy flexor tendon sheath to cover the site of the repaired flexor tendon. There was a low success rate due to technical difficulties in the immobilisation of the monkey fingers. Where the finger was successfully immobilised the results were encouraging.


1996 ◽  
Vol 21 (4) ◽  
pp. 463-468 ◽  
Author(s):  
A. MESSINA ◽  
J. C. MESSINA

The direct midlateral approach and the lateral enlarging procedure of the pulley system have been utilized in our service since 1972. The incision runs directly behind the neurovascular pedicle, which is left in the palmar skin flap of the anterior compartment of the finger, in order to ensure its blood supply and sensibility. The transverse digital lamina of Landsmeer’s skin anchoring system and Cleland’s ligament are preserved and are used to perform a lateral enlargement of the pulleys after tendon repair. The technique allows wide surgical exposure of the digital fibro-osseous tunnel, enlargement and reconstruction of the pulley system and tendon sheath, flexor tendon repair (using the technique of choice) and reduces postoperative impingement in zone 2.


HAND ◽  
1978 ◽  
Vol os-10 (1) ◽  
pp. 37-47 ◽  
Author(s):  
Hilton Becker

summary A new approach to the problem of flexor tendon repair within the fibro-osseous canal is presented. Using a technique of bevelling the tendon ends and suturing with a fine suture material, under magnification, a sufficiently strong junction is obtained, which enables immediate active mobilisation without strangulation of the blood supply. The junction can resist gap formation up to tensions of 4 Kg. It is postulated that under these conditions tendon nutrition is minimally interfered with, adhesions do not form, and the tendon heals by its own intrinsic healing ability.


2003 ◽  
Vol 28 (2) ◽  
pp. 113-115 ◽  
Author(s):  
A. GOLASH ◽  
A. KAY ◽  
J. G. WARNER ◽  
F. PECK ◽  
J. S. WATSON ◽  
...  

A prospective double-blind, randomized, controlled clinical trial was conducted to assess the use of ADCON-T/N after flexor tendon repair in Zone II. Forty-five patients with 82 flexor tendon repairs in 50 digits completed the study. ADCON-T/N was injected into the tendon sheath after tenorrhaphy in the experimental group while the control group was not treated with ADCON-T/N. ADCON-T/N had no statistically significant effect on total active motion at 3, 6 and 12 months but the time taken to achieve the final range of motion was significantly shorter in treated patients. ADCON-treated patients had a higher rupture rate but this was not significant.


2005 ◽  
Vol 30 (6) ◽  
pp. 626-632 ◽  
Author(s):  
J. C. BERSCHBACK ◽  
P. C. AMADIO ◽  
C. ZHAO ◽  
M. E. ZOBITZ ◽  
K. N. AN

Flexor tendon repair remains one of the more difficult technical tasks facing the hand surgeon. A good repair must be both strong and able to glide smoothly through the tendon sheath. The purpose of this study is to present a model that allows surgeons to improve their technique of flexor tendon repair by receiving feedback on these important biomechanical parameters. The set-up requires testing equipment found in most biomechanical laboratories and should be available in many academic medical centres. Preliminary data suggest that receiving feedback about the strength and smoothness of a flexor tendon repair may be a very useful tool in helping surgeons improve the overall quality of their tendon repair technique.


Hand Surgery ◽  
2009 ◽  
Vol 14 (02n03) ◽  
pp. 125-129 ◽  
Author(s):  
Hithoshi Hatanaka ◽  
Tetsuo Kojima ◽  
Tomoyuki Miyagi ◽  
Tomoyuki Mizoguchi ◽  
Yoshifumi Ueshin

The authors present the clinical outcomes of nine zone 2 flexor tendon repairs using a locking loop technique (i.e. the Modified Pennington technique). The locking loops were located approximately 10 mm away from the lacerated tendon ends to "lengthen" the locking loop repair, as experimentally and clinically recommended. The partial lateral release of the tendon sheath, including the A2 and/or A4 pulley, was performed not only to locate the sutures but also to allow a full range of motion of the repair without catching on the tendon sheath, as clinically recommended. All the patients were followed up for six months or more except for one. All digits were evaluated as excellent or good at the final follow-up by the original Strickland criteria. No rupture occurred and no bowstring of the flexor tendon was observed. The clinical outcomes of the current study indicate that "lengthening" the locking loop repair is effective for zone 2 flexor tendon repair and that the partial lateral release of the tendon sheath, including the A2 and/or A4 pulley, does not result in the bowstring of the flexor tendon.


1996 ◽  
Vol 21 (1) ◽  
pp. 72-83 ◽  
Author(s):  
T. S. OEI ◽  
P. J. KLOPPER ◽  
J. A. J. SPAAS ◽  
P. BUMA

The role of the tendon sheath in flexor tendon healing was investigated in rabbits. Tendon sheath was reconstructed with syngeneic parietal peritoneum or a non-tanned processed porcine collagen membrane. Resection of the tendon sheath led to adhesions. Reconstruction of the sheath with either graft resulted in a synovial–like lining, resembling a neo-tendon sheath. Even when combined with tendon repair a neo-tendon sheath was seen after reconstruction with both grafts, without adhesions. Subcutaneously implanted processed porcine collagen membrane was completely resorbed in less than 3 months.


1997 ◽  
Vol 22 (1) ◽  
pp. 122-124 ◽  
Author(s):  
A. ADENIRAN ◽  
A. Z. BABAR

A relatively atraumatic, simple and very reliable method of retrieving the proximal end of a severed flexor tendon of a finger or thumb is described. The technique involves passing a Silastic feeding tube into the flexor tendon sheath, placing the retracted tendon within its lumen, and securing it in place with a single stitch. The feeding tube is then withdrawn until the tendon presents within the distal wound. Hypodermic needle fixation and tendon repair is then carried out in the usual manner.


HAND ◽  
1983 ◽  
Vol os-15 (2) ◽  
pp. 123-135 ◽  
Author(s):  
Graham D. Lister

In order to gain closure of the flexor tendon sheath after tendon repair, onsideration is given to the method of opening the sheath, its siting and the method of tendon suturing.


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