scholarly journals Comparison of an All-Inside Suture Technique With Traditional Pull-Out Suture and Suture Anchor Repair Techniques for Flexor Digitorum Profundus Attachment to Bone

2013 ◽  
Vol 38 (6) ◽  
pp. 1084-1090 ◽  
Author(s):  
Jennifer Y. Chu ◽  
Tony Chen ◽  
Hani A. Awad ◽  
John Elfar ◽  
Warren C. Hammert
Keyword(s):  
Suture Anchor ◽  
Suture Technique ◽  
Flexor Digitorum Profundus ◽  
Pull Out ◽  
Flexor Digitorum ◽  
Pull Out Suture ◽  
Suture Anchor Repair ◽  
Repair Techniques

Repair Technique Using a Combination of Suture Anchor and Miniscrew in Flexor Digitorum Profundus Bony Avulsion Fracture with Bone Fragment in Zone 1

2018 ◽  
Vol 23 (03) ◽  
pp. 430-436
Author(s):  
Jae-Hwi Nho ◽  
Sang-Woo Lee ◽  
Mi-Ae Nam ◽  
Byung-Sung Kim ◽  
Ki Jin Jung
Keyword(s):  
Suture Anchor ◽  
Avulsion Fracture ◽  
Flexor Tendon ◽  
Tendon Injuries ◽  
Flexor Digitorum Profundus ◽  
Rare Injury ◽  
Pull Out ◽  
Bony Avulsion ◽  
Flexor Tendon Injuries ◽  
Pull Out Suture

Avulsion fracture of the volar base of the distal phalanx is a rare injury. Zone 1 flexor tendon injuries can be treated with either internal or external fixation techniques. Pull-out suture repairs are often used for FDP tendon avulsion injuries. However, the pull out suture technique is associated with a number of well documented complications including nail bed injury and pressure necrosis. Despite the variety of techniques available for the repair of acute distal zone 1 flexor tendon injuries, no one technique has proven to be superior to all others. We address our experience with treatment of FDP avulsion injuries using suture anchor and miniscrew. Our technique supplements the suture anchor technique, which often causes a lack of strength, with an additional miniscrew. We introduce two cases of combined method using both suture anchor and miniscrew for treatment of FDP avulsion injuries.

MODIFIED BRUNELLI PULL-OUT SUTURE TECHNIQUE IN ZONE II FLEXOR TENDON RUPTURE: A FRESH HUMAN CADAVER STUDY

Hand Surgery ◽  
2014 ◽  
Vol 19 (03) ◽  
pp. 349-355
Author(s):  
Hakan Başar ◽  
Cihangir Tetik
Keyword(s):  
Suture Technique ◽  
Flexor Digitorum Profundus ◽  
Control Group ◽  
Study Group ◽  
Gap Formation ◽  
Active Motion ◽  
Average Load ◽  
Pull Out ◽  
Pull Out Suture ◽  
Flexion And Extension

Purpose: The aim of our study is to develop a suture technique that has sufficient strength of active mobilization. Methods: Thirty two fingers of six fresh human cadavers were divided into two groups. Flexor digitorum profundus (FDP) tendons in the study group were repaired by modified Brunelli suture technique and modified Kessler suture technique, while those in the control group were repaired by Modified Kessler suture technique. Flexion and extension movements were performed with 10 N of load, increasing 1 N at a time to the tendons in both groups. Rupture and significant gap formation was evaluated up to 20 N of load. In the study, to evaluate the resistance to active motion, 1000 times flexion and extension motion cycle was performed with a load of 20 N. The succeeding repaired tendons was also tested with flexion and extension movements increasing the load 1 N at a time. Results: In the study group, failure and significant gap formation on the repair zone were not observed after 20 N of load and 1000 times cyclic flexion and extension movements for resisting to active motion. The rupture and significant gap formation was observed on a average load of 98.43 ± 0.47 N. In the Modified Kessler suture technique, on the eight tendons before reaching the 20 N of load for resisting to active motion, and the remaining eight tendons, during the 20 N loaded motion cycle essential for active motion, rupture and significant gap formation was observed. The failure and significant gap formation was observed on a average load of 18.37 ± 1.89 N. It is measured that by accompanying Modified Brunelli suture to the Modified Kessler suture technique, the resistance was increased up to 5–6 times. Discussion: By the Modified Brunelli suture technique, active motion can be started to the finger without a dorsal block sling immediately after the surgery. Clinical Relavans: By the modified technique, the rehabilitation difficulty and joint stiffness will be minimized.

scholarly journals The effect of tissue culture on suture holding strength and degradation in canine tendon

2009 ◽  
Vol 34 (5) ◽  
pp. 643-650 ◽  
Author(s):  
H. OMAE ◽  
C. ZHAO ◽  
Y.-L. SUN ◽  
M. E. ZOBITZ ◽  
S. L. MORAN ◽  
...  
Keyword(s):  
Tissue Culture ◽  
Tensile Load ◽  
Flexor Digitorum Profundus ◽  
Tendon Suture ◽  
Pull Out ◽  
Culture Model ◽  
Static Tensile ◽  
Tissue Culture Model ◽  
Flexor Digitorum ◽  
Pull Out Strength

The purpose of this study was to assess tendon metabolism and suture pull-out strength after simple tendon suture in a tissue culture model. One hundred and twelve flexor digitorum profundus tendons from 28 dogs were cultured for 7, 14, or 21 days with or without a static tensile load. In both groups increased levels of matrix metalloproteinase (MMP) mRNA was noted. Suture pull-out strength did not decrease during tissue culture. While the presence of a static load had no effect on the pull-out strength, it did affect MMP mRNA expression. This tissue culture model could be useful in studying the effect of factors on the tendon-suture interface.

Opening wedge phalangeal osteotomy for correction of Wassel type IV-D thumb duplication

2019 ◽  
Vol 52 (02) ◽  
pp. 147-150
Author(s):  
Kun Wang ◽  
Fangxin Ai ◽  
Pan Zhou ◽  
Zhiwei Liu ◽  
Zhenbing Chen ◽  
...  
Keyword(s):  
Metacarpophalangeal Joint ◽  
Suture Technique ◽  
Wedge Osteotomy ◽  
Angular Deformity ◽  
Opening Wedge ◽  
Type Iv ◽  
Pull Out ◽  
Thumb Duplication ◽  
The Right ◽  
Pull Out Suture

Abstract Background Thumb duplication is one of common anomalies of the hand. Among of Wassel type IV subtypes, type IV-D duplication with a zigzag deformity is most challenging for reconstructing. Several factors may affect the surgical outcomes. This study aimed to present an opening wedge osteotomy at proximal phalangeal neck for treating type IV-D duplication. Methods Data from 14 patients are presented in this study. Eight patients had duplication of the right thumb, and six left thumb. After removal of radial supernumerary thumb, a snug collateral ligament was repaired to correct angular deformity of metacarpophalangeal joint (MCP). Angular deformity of the interphalangeal (IP) joint was corrected by an opening wedge osteotomy at the proximal phalangeal neck. A wedge bone from ablated thumb was grafted to correct the malalignment. IP joint was further stabilized by plication of the ulnar capsule. The relocation of radial part of FPL to the center of distal phalangeal base by use of pull-out suture technique Results After surgery, the angulations of the IP joints and the MCP joints were improved. Bone union was observed in all patients. According to the Japanese Society for Surgery of the Hand evaluation form, twelve cases were rated good, 2 cases fair. Stability of IP and MCP joints was good in all cases. The active ROM of IP was less in residual thumb than in normal thumb. Small nails were observed in some patients. Conclusions Although the reconstructed thumbs were smaller than normal counterparts, they were aligned and with stable joints. The opening wedge osteotomy at proximal phalangeal neck could improve realignment of IP joint and prevent reoccurrence of deformity over time.

scholarly journals Arthroscopic Quadriceps Tendon Repair: Two Case Reports

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Hidetomo Saito ◽  
Yoichi Shimada ◽  
Toshiaki Yamamura ◽  
Shin Yamada ◽  
Takahiro Sato ◽  
...  
Keyword(s):  
Suture Anchor ◽  
Case Reports ◽  
Tendon Repair ◽  
Quadriceps Tendon ◽  
Tendon Injury ◽  
Arthroscopic Repair ◽  
Pull Out ◽  
One Year ◽  
Bone Tunnels ◽  
Pull Out Suture

Recently, although some studies of open repair of the tendon of the quadriceps femoris have been published, there have been no reports in the literature on primary arthroscopic repair. In our present study, we present two cases of quadriceps tendon injury arthroscopically repaired with excellent results. Case 1 involved a 68-year-old man who was injured while shifting his weight to prevent a fall. MRI showed complete rupture at the insertion of the patella of the quadriceps tendon. The rupture was arthroscopically repaired using both suture anchor and pull-out suture fixation methods via bone tunnels (hereafter, pull-out fixation). Two years after surgery, retearing was not observed on MRI and both Japan Orthopedic Association (JOA) Knee and Lysholm scores had recovered to 100. Case 2 involved a 50-year-old man who was also injured when shifting his weight to prevent a fall. MRI showed incomplete superficial rupture at the insertion of the patella of the quadriceps tendon. The rupture was arthroscopically repaired using pull-out fixation of six strand sutures. One year after surgery, MRI revealed a healed tendon and his JOA and Lysholm scores were 95 and 100, respectively. Thus, arthroscopic repair may be a useful surgical method for repairing quadriceps tendon injury.

Isolated flexor digitorum profundus tendon injuries in zones IIA and IIB repaired with figure of eight sutures

2010 ◽  
Vol 36 (2) ◽  
pp. 147-153 ◽  
Author(s):  
M. M. Al-Qattan
Keyword(s):  
Tendon Repair ◽  
Suture Technique ◽  
Tendon Injuries ◽  
Flexor Digitorum Profundus ◽  
Major Disadvantage ◽  
Zone Ii ◽  
Flexor Digitorum ◽  
Flexor Digitorum Profundus Tendon ◽  
Tendon Laceration

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.

Rotator Cuff Repair: An Ex Vivo Analysis of Suture Anchor Repair Techniques on Initial Load to Failure

2005 ◽  
Vol 21 (10) ◽  
pp. 1236-1241 ◽  
Author(s):  
Craig A. Cummins ◽  
Richard C. Appleyard ◽  
Sabrina Strickland ◽  
Pieter-Stijn Haen ◽  
Shiyi Chen ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Suture Anchor ◽  
Ex Vivo ◽  
Initial Load ◽  
Load To Failure ◽  
Cuff Repair ◽  
Suture Anchor Repair ◽  
Repair Techniques
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