A transverse pull-through suture technique to repair volar plate avulsion for a chronic swan neck deformity

2016 ◽  
Vol 69 (5) ◽  
pp. 729-731
Author(s):  
Kana Miyagi ◽  
Muhammad Riaz
Keyword(s):  
Suture Technique ◽  
Volar Plate ◽  
Pull Through ◽  
Swan Neck Deformity

scholarly journals OV07 LAPAROSCOPIC HIATAL HERNIA MESH-SUTURE REPAIR

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Alexey Abolmasov
Keyword(s):  
Hiatal Hernia ◽  
Paraesophageal Hernia ◽  
Suture Line ◽  
Suture Technique ◽  
Force Distribution ◽  
Suture Repair ◽  
Hernia Defect ◽  
Hernia Mesh ◽  
Pull Through

Abstract Aim “A new original laparoscopic operative technique was used to suture paraesophageal hernia (PEH) with the strips of mesh. Material and Methods The Mercilen (MercilenTM) mesh suture was used to close large hiatal hernia. The strips of mesh, instead of normal thread, were applied to close the gap between diaphragm’s crura in 12 patients with hernia defect more than 5 cm. Mesh suture were tighten as a simple laparoscopic intracorporeal knot. The surgical technique and surgical outcomes are presented. Results 12 patients underwent a laparoscopic PEH suturing with Mercilen strips of mesh. We recorded no recurrence or dysphagia at 6 and 12 months follow-up. Conclusions Mesh-sutured repairs of diaphragm’s hernia support the concepts of force distribution and resistance to suture pull through. The new original technique avoids using the sheet of mesh and enables to reduce the amount of dangerous complications connected with mesh and its fixation. Mesh-sutured closures of hiatal hernias seem to be safe and effective in tension closure of large hiatal defects. Further investigations are needed to evaluate the results. Using the mesh suture technique for the closure of large PEH, we protect the cruras from being cutting through. Besides, the mesh stripes and its knots produce tissue scarring around the esophagus making the suture line stronger.

The Pop-Out, Pull-Through Suture Technique

1993 ◽  
Vol 13 (3) ◽  
pp. 156-157
Author(s):  
Marguerite Haines
Keyword(s):  
Suture Technique ◽  
Pull Through

Development of an In Vitro Swan Neck Deformity Biomechanical Model

Hand ◽  
2020 ◽  
pp. 155894472096673
Author(s):  
Mohammad M. Haddara ◽  
Stacy Fan ◽  
Bogdan A. Matache ◽  
Shrikant J. Chinchalkar ◽  
Louis M. Ferreira ◽  
...  
Keyword(s):  
In Vitro Model ◽  
Volar Plate ◽  
Strong Positive Correlation ◽  
Mallet Finger ◽  
Active Motion ◽  
Motion Simulator ◽  
Flexion Extension ◽  
Vitro Model ◽  
Swan Neck Deformity

Background: Injury to the finger’s extensor mechanism is a common cause of swan neck deformity (SND). Progression of extensor and flexor tendon imbalance negatively affects laxity of the volar plate, resulting in the inhibition of proper finger motion. The complexity of finger anatomy, however, makes understanding the pathomechanics of these deformities challenging. Therefore, development of an SND model is imperative to understand its influence on finger biomechanics and to provide an in vitro model to evaluate the various treatment options. Methods: The index, middle, and ring fingers from 8 cadaveric specimens were used in an in vitro active motion simulator to replicate finger flexion/extension. An SND model was developed through sectioning of the terminal extensor tendon at the distal insertion (creating a mallet finger) and transverse retinacular ligament (TRL). A strain gauge inserted under the volar plate measured laxity of the plate, and electromagnetic trackers recorded proximal interphalangeal joint (PIPJ) angles. Results: Strain in the volar plate increased progressively with creation of the mallet and SND conditions ( P = .015). Although not statistically significant, the mallet finger condition accounted for 26% of the increase, whereas sectioning of the TRL accounted for 74% ( P = .031). As predicted, PIPJ hyperextension was not detectable by joint angle measurement; however, the PIPJ angle had a strong positive correlation with volar plate strain ( R2 = 1.0, P < .001). Conclusion: Volar plate strain measurement, in an in vitro model, can detect an induced SND. Moreover, as a surrogate for PIPJ hyperextension, volar plate strain may be useful to evaluate the time-zero effectiveness of various surgical interventions.

scholarly journals Arthroscopic pull-through suture for tibial eminence avulsion fracture: a case series

2020 ◽  
Vol 8 (12) ◽  
pp. 4471
Author(s):  
Mario D. Simatupang ◽  
I. G. N. Wien Aryana ◽  
Hans K. Nugraha
Keyword(s):  
Knee Pain ◽  
Traffic Accident ◽  
Avulsion Fracture ◽  
Case Series ◽  
International Knee Documentation Committee ◽  
Suture Technique ◽  
Fixation Method ◽  
Long Distance ◽  
Tibial Eminence ◽  
Pull Through

Fractures of the tibial eminence is commonly reported in adolescents and adults, due to traffic accident, sports injury, or any other mechanism. Case 1: a 12-year-old male complained knee pain after a traffic accident 2 months prior to visit. Case 2: a 31-year-old female complained knee pain which worsened with long-distance walking and sitting, after falling on her knees one month prior to visit. Case 3: a 27-year-old female complained a worsening knee pain after traffic accident 12 years ago. Although it has been extensively studied, controversies regarding the best fixation method still exist. Open technique was once popular, but some morbidity has been associated with this method. Therefore, a new approach using arthroscopic pull-through suture technique, albeit technically challenging, is currently being advocated as a treatment option for such fractures. The result in our series confirm that all of 3 patients have a good result based on international knee documentation committee (IKDC) scoring for evaluation the treatment, hence support the use of this novel technique for the patients with tibial eminence avulsion fracture.

Flexor Digitorum Superficialis Tendon Sling Volar Plate Reconstruction for Swan-Neck Deformity in the Spastic Finger

2017 ◽  
Vol 22 (02) ◽  
pp. 251-254
Author(s):  
Y.L. Tan ◽  
F.C. Yong
Keyword(s):  
Tendon Graft ◽  
Proximal Interphalangeal Joint ◽  
Volar Plate ◽  
Safe Procedure ◽  
Flexor Digitorum Superficialis ◽  
Reconstruction Procedure ◽  
Sling Procedure ◽  
Flexor Digitorum ◽  
Plate Reconstruction ◽  
Swan Neck Deformity

The condition of proximal interphalangeal joint (PIPJ) locking in hyperextension may occur in the athetoid or spastic hand with moderate or severe swan-neck deformity at the ‘opening’ phase of prehension. The patient’s complaints are of complete or incomplete locking that may require passive assistance to initiate PIPJ flexion. Surgical procedures to overcome this include rerouting the lateral band, stabilisation or reconstruction procedure for the volar instability of the PIPJ, etc. Volar stabilisation may be achieved by Flexor digitorum superficialis (FDS) tenodesis procedures or criss-cross tendon graft for volar plate reconstruction. We report a case of successful stabilisation using the criss-cross tendon sling procedure for volar plate reconstruction using a slip of the FDS tendon instead of a free tendon graft. This is a simple and safe procedure that effectively corrects the swan-neck deformity and improves the prehension function in the hand.

scholarly journals Chronic post-traumatic volar plate avulsions of the finger proximal interphalangeal joint: A literature review of different surgical techniques

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Daniele Caviglia ◽  
Gianluca Ciolli ◽  
Camillo Fulchignoni ◽  
Lorenzo Rocchi
Keyword(s):  
Surgical Techniques ◽  
Flexion Contracture ◽  
Proximal Interphalangeal Joint ◽  
Suture Technique ◽  
Interphalangeal Joint ◽  
Volar Plate ◽  
Post Traumatic ◽  
Object Of Study ◽  
Surgical Treatments ◽  
Phalangeal Fractures

Avulsions of the volar plate of the finger proximal interphalangeal joint (PIPJ) following sprains are often undiagnosed in the acute setting. Therefore, the chronic outcomes of this injury are most frequently the object of study and treatment. Different techniques for volar plate chronic avulsion repair are described in the literature. The most used among these are mainly two: the direct suturing with or without the use of bone anchors and the tenodesis techniques with flexor digitalis superficialis (FDS). The aim of this systematic review is to determine outcomes and complications associated with these surgical treatments of post-traumatic volar plate avulsions without phalangeal fractures. An electronic literature research was carried out and pertinent articles were selected. Surgical techniques details, outcomes and complications for direct sutures and tenodesis technique are discussed. Outcomes (Range of motion and pain) seem to be comparable, whereas authors that use the direct suture technique describe more frequently PIPJ flexion contracture complication. From this review of the literature, authors believe that both techniques are available for the repair of chronic injuries of the volar plate of the PIPJ, although direct suturing can be considered as less reproducible.

Volar transfer of the lateral band with transverse retinacular ligament is effective for the correction of swan-neck deformity caused by volar plate injury of the PIP joint

2019 ◽  
Vol 4 (1) ◽  
pp. 152-155
Author(s):  
Masahiro Sato ◽  
Taku Suzuki ◽  
Takuji Iwamoto ◽  
Noboru Matsumura ◽  
Hiroo Kimura ◽  
...  
Keyword(s):  
Volar Plate ◽  
Lateral Band ◽  
Pip Joint ◽  
Swan Neck Deformity

CLINICAL OUTCOME OF ARTHROSCOPIC REDUCTION AND FIXATION BY PULL THROUGH SUTURE TECHNIQUE IN TIBIAL SPINE FRACTURES

2021 ◽  
pp. 17-20
Author(s):  
Ravi Shankar ◽  
Arunim Swarup ◽  
Rahul Kumar Gupta ◽  
Sunil Malhotra ◽  
Sparsh Jaiswal
Keyword(s):  
Clinical Outcome ◽  
Range Of Motion ◽  
Suture Technique ◽  
Lysholm Score ◽  
Spine Fractures ◽  
Lachman Test ◽  
Tibial Spine ◽  
Ikdc Score ◽  
Pull Through

Background -Tibial spine avulsion fracture is bony avulsions of anterior cruciate Ligament (ACL) from its attachment on the anteromedial portion of the intercondylartibial eminence. If not treated well, Tibial spine fractures can lead to non-union or malunion, which can lead to signicant disability in the form of exion deformity,loss of extension, or instability. Aims And Objectives: This study was conducted with the aim of evaluating clinical outcome of arthroscopic reduction and xation of fractures by pull through suture technique and complications associated with the procedure. Thi Material And Method: s prospective with retrospective study analyzed 20 patients (16 males and 4 females), with mean age of 28.6 ± 9.8 years (range, 15-55). Patients were classied by Meyers and Mckeever type III (n=16) and IV (n=4) and were operated arthroscopically by pull through suture technique. They were followed over a mean period of 10±2.8 months. Postoperative assessment was done by using Lachman test, Lysholm knee score and international knee documentation Committee (IKDC) score. Objective assessment of anterior translation of tibia was done by using indigenously developed device named Laxometer. At the end of follow up,17 of 20 patient had no or minimal anterior transl Results: ation of tibia by Lachman test. The mean preoperative Lysholm score in 20 knees was 38 (range 29 to 55) and mean post-operative Lysholm score was 96 (range 83-100). At the end of follow up 17 of 20 (85%) patients accessed by IKDC score were normal/ nearly normal grade A/B and 3 patients were abnormal (grade C). All patients achieved union within 3 months (range 8 to 17 weeks). 20% patients had restricted range of motion. Arthroscopic pull Conclusion: through suture technique has good clinical outcomes in both type III and type IV fractures, and in all age groups (open and closed physis) with minimal complications. This was evidenced by no instability and residual ACL deciency, postoperatively at 1 year. Most patients have excellent recovery with full return of knee range of motion.

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