Flexor Tendon Repair in “No Man's Land” An Experimental Study

HAND ◽  
1977 ◽  
Vol os-9 (2) ◽  
pp. 143-146
Author(s):  
A. R. Moscona ◽  
R. Sekel ◽  
E. R. Owen
Keyword(s):  
Experimental Study ◽  
Success Rate ◽  
Flexor Tendon ◽  
Tendon Repair ◽  
Tendon Sheath ◽  
Flexor Tendon Repair ◽  
Flexor Tendon Sheath ◽  
No Man's Land

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.

A New Approach to Flexor Tendon Repair

1994 ◽  
Vol 19 (4) ◽  
pp. 513-516 ◽  
Author(s):  
P. P. CALLAN ◽  
W. A. MORRISON
Keyword(s):  
Flexor Tendon ◽  
Tendon Repair ◽  
Tendon Sheath ◽  
Simple Approach ◽  
Flexor Tendon Repair ◽  
New Approach ◽  
Flexor Tendon Sheath

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

Methods of Evaluation of the Functional Results of Flexor Tendon Repair of the Fingers

1985 ◽  
Vol 10 (1) ◽  
pp. 60-61 ◽  
Author(s):  
A. B. NIELSEN ◽  
P. Ø. JENSEN
Keyword(s):  
Functional Outcome ◽  
Standard Method ◽  
Flexor Tendon ◽  
Tendon Repair ◽  
Functional Results ◽  
Functional Evaluation ◽  
Flexor Tendon Repair ◽  
Methods Of Evaluation ◽  
Method Of Measurement ◽  
No Man's Land

The methods used by Buck-Gramcko, Kleinert and Tsuge in evaluating the functional results of flexor tendon repair were each applied to assess the functional outcome in sixty-seven fingers where both tendons had been severed in “no man's land”. The method of Buck-Gramcko gave the highest rating, and the three methods showed evident differences in the results of evaluation after surgery. The study suggests a need for one standard method of measurement and recording, if a comparison of results after flexor tendon repair is to be of value. We found that the method of Buck-Gramcko incorporated the most essential features in the functional evaluation.

The Direct Midlateral Approach with Lateral Enlargement of the Pulley System for Repair of Flexor Tendons in Fingers

1996 ◽  
Vol 21 (4) ◽  
pp. 463-468 ◽  
Author(s):  
A. MESSINA ◽  
J. C. MESSINA
Keyword(s):  
Flexor Tendon ◽  
Skin Flap ◽  
Tendon Repair ◽  
Tendon Sheath ◽  
Flexor Tendon Repair ◽  
Anterior Compartment ◽  
Pulley System ◽  
Neurovascular Pedicle ◽  
Anchoring System ◽  
Palmar Skin

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.

Efficacy of Adcon-T/N After Primary Flexor Tendon Repair in Zone II: A Controlled Clinical Trial

2003 ◽  
Vol 28 (2) ◽  
pp. 113-115 ◽  
Author(s):  
A. GOLASH ◽  
A. KAY ◽  
J. G. WARNER ◽  
F. PECK ◽  
J. S. WATSON ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Flexor Tendon ◽  
Tendon Repair ◽  
Tendon Sheath ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Flexor Tendon Repair ◽  
Double Blind ◽  
Active Motion ◽  
Zone Ii

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.

Delayed flexor tendon repair in no man's land

1977 ◽  
Vol 2 (6) ◽  
pp. 452-455 ◽  
Author(s):  
Lawrence H. Schneider ◽  
James M. Hunter ◽  
Tom R. Norris ◽  
Paul O. Nadeau
Keyword(s):  
Flexor Tendon ◽  
Tendon Repair ◽  
Flexor Tendon Repair ◽  
No Man's Land

Providing Quantitative Feedback When Teaching Tendon Repair: A New Tool

2005 ◽  
Vol 30 (6) ◽  
pp. 626-632 ◽  
Author(s):  
J. C. BERSCHBACK ◽  
P. C. AMADIO ◽  
C. ZHAO ◽  
M. E. ZOBITZ ◽  
K. N. AN
Keyword(s):  
Flexor Tendon ◽  
Tendon Repair ◽  
Tendon Sheath ◽  
Flexor Tendon Repair ◽  
Hand Surgeon ◽  
Repair Technique ◽  
Academic Medical ◽  
Biomechanical Parameters ◽  
Set Up

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.

LENGTHENING THE LOCKING LOOP REPAIR FOR ZONE 2 FLEXOR TENDON LACERATION AND PARTIAL LATERAL RELEASE OF THE TENDON SHEATH

Hand Surgery ◽  
2009 ◽  
Vol 14 (02n03) ◽  
pp. 125-129 ◽  
Author(s):  
Hithoshi Hatanaka ◽  
Tetsuo Kojima ◽  
Tomoyuki Miyagi ◽  
Tomoyuki Mizoguchi ◽  
Yoshifumi Ueshin
Keyword(s):  
Clinical Outcomes ◽  
Flexor Tendon ◽  
Full Range ◽  
Tendon Repair ◽  
Tendon Sheath ◽  
Lateral Release ◽  
Flexor Tendon Repair ◽  
Loop Technique ◽  
Tendon Laceration

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.

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