Tension Reducing Muscle Stretch Protocol to Obtain Full Distal Tendon Excursion: A New Rehabilitation Protocol after Flexor Tendon Repair

2021 ◽  
Author(s):  
Sotetsu Sakamoto ◽  
Kazuteru Doi ◽  
Yasunori Hattori ◽  
Dawn Sinn Yii Chia ◽  
Kota Hayashi
Keyword(s):  
Flexor Tendon ◽  
Tendon Repair ◽  
Flexor Tendon Repair ◽  
Muscle Stretch ◽  
Rehabilitation Protocol ◽  
Distal Tendon ◽  
Tendon Excursion

Improved tendon excursion following flexor tendon repair

1989 ◽  
Vol 2 (2) ◽  
pp. 102-106 ◽  
Author(s):  
W.P. Cooney ◽  
G.T. Lin ◽  
Kai-Nan An
Keyword(s):  
Flexor Tendon ◽  
Tendon Repair ◽  
Flexor Tendon Repair ◽  
Tendon Excursion

scholarly journals An analysis of the effect of the technique of the repair and postoperative rehabilitation protocol on the treatment outcomes of flexor tendon injuries: a review

2020 ◽  
Vol 66 (3) ◽  
Author(s):  
Andrzej Żyluk ◽  
Bernard Piotuch
Keyword(s):  
Treatment Outcomes ◽  
Flexor Tendon ◽  
Scientific Evidence ◽  
Tendon Repair ◽  
Conclusive Evidence ◽  
Tendon Injuries ◽  
Flexor Tendon Repair ◽  
Postoperative Rehabilitation ◽  
Rehabilitation Protocol ◽  
Flexor Tendon Injuries

This study covers updated information on the methods of the repair of flexor tendon injuries, postoperative rehabilitation protocols and their effect on treatment outcomes. Contemporary techniques of flexor tendon repair are based on combinations of various types of core sutures and circumferential epitenon sutures. Literature shows a tendency of replacing earlier 2-strand core tendon sutures with novel multistrand core sutures, however the results of meta-analyses do not confirm any definitive superiority over traditional techniques. Likewise, literature does not provide conclusive evidence that early active postoperative mobilization results in better outcomes than active-passive and controlled passive mobilization techniques. The choice of the method of flexor tendon repair and postoperative rehabilitation protocol depends only in part on scientific evidence, but more on individual or institutional preference of the surgeon.

Evaluation of flexor tendon repair (zone II) with Wide Awake Anesthesia

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ahmed Adel Zaghloul Fayed ◽  
Naglaa Mohamed Abdel Aziz ◽  
Ebrahim Mohamed Amin Abdel Gawad ◽  
Ibrahim Hussien Kamel ◽  
Ahmed Elshahat
Keyword(s):  
Flexor Tendon ◽  
Tendon Repair ◽  
Tendon Injuries ◽  
Flexor Tendon Repair ◽  
Active Motion ◽  
Rehabilitation Protocol ◽  
Flexor Tendon Injuries ◽  
Zone Ii ◽  
Active Rehabilitation ◽  
Wide Awake

Abstract Background Recent advances in hand surgery has been the movement away from tourniquet surgery, which often requires sedation or GA and the patient will be awake and cooperative. Wide awake approach depends on the safety of adrenaline which is now well established. This review will evaluate the role of the wide awake approach in reducing rupture and tenolysis rate after flexor tendon repair zone 2. Objective To evaluate the functional outcome of flexor tendon repair zone II (most challengeable) under wide awake anesthesia. Patients and Methods After approval of local ethical committee of faculty of medicine Ain Shams University, this Prospective study has been conducted targeting patients with acute zone II flexor tendon injuries admitted at El Sahel Teaching Hospital within the period from September 2019 till January 2020, and their follow up for minimum three months at outpatient clinic. A Written informed consent explaining the whole procedure under study in this research has been obtained from all patients and absolute confidentiality as regard the patients’ names and addresses was given special care and attention. Final outcome evaluated by Original Strickland evaluation system. Results Using the wide awake technique provides an optimal opportunity to test repair strength through Intra-operative Total Active Movement (ITAM) making the surgeon much more comfortable to initiate early active motion. Besides, rising trend toward using early active rehabilitation protocol in case of strong repair using four or more strands repairs is recently supported in literature. This study adopted early active rehabilitation protocol with slight differences among them Conclusion This preliminary study assessing the outcomes of primary tendon repair in flexor tendon injuries in zone II using the wide-awake technique demonstrates encouraging results, being satisfactory for both surgeons and patients that makes this new approach a competitive to the other approaches of flexor tendon repair implemented under conventional methods of anesthesia.

scholarly journals Ischaemic contracture of the hand

2006 ◽  
Vol 39 (01) ◽  
pp. 94-102
Author(s):  
G. Balakrishnan
Keyword(s):  
Suture Material ◽  
Flexor Tendon ◽  
Tendon Repair ◽  
Hypodermic Needle ◽  
Flexor Tendon Repair ◽  
Active Motion ◽  
Custom Made

ABSTRACTStronger flexor tendon repairs facilitate early active motion therapy protocols. Core sutures using looped suture material provide 1 ½ to twice the strength of Kessler′s technique (with four strand and six strand Tsuge technique respectively). The technique is well-described and uses preformed looped sutures (supramid). This is not available in many countries and we describe a technique whereby looped sutures can be introduced in flexor tendon repair by the use of 23 G hypodermic needle and conventional 4.0 or 5.0 sutures. This is an alternative when the custom made preformed sutures are not available. This can be practiced in zone 3 to zone 5 repairs. Technical difficulties limit its use in zone 2 repairs.

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.

Looped suture properties: implications for multistranded flexor tendon repair

2015 ◽  
Vol 40 (3) ◽  
pp. 234-238 ◽  
Author(s):  
R. Haddad ◽  
T. Peltz ◽  
N. Bertollo ◽  
W. R. Walsh ◽  
S. Nicklin
Keyword(s):  
Mechanical Properties ◽  
Flexor Tendon ◽  
Tendon Repair ◽  
Relative Effect ◽  
Flexor Tendon Repair ◽  
Polypropylene Monofilament ◽  
Single Suture ◽  
Biomechanical Strength ◽  
Standard Techniques ◽  
Repair Techniques

Multiple-strand repair techniques are commonly used to repair cut flexor tendons to achieve initial biomechanical strength. Looped sutures achieve multiple strands with fewer passes and less technical complexity. Their biomechanical performance in comparison with an equivalent repair using a single-stranded suture is uncertain. This study examined the mechanical properties of double-stranded loops of 3-0 and 4-0 braided polyester (Ticron) and polypropylene monofilament (Prolene). Double loops were generally less than twice the strength of a single loop. Ticron and Prolene had the same strengths, but Ticron was stiffer. The 4-0 double loops had significantly higher stiffness than 3-0 single loops. Increasing the size of sutures had a larger relative effect on strength than using a double-stranded suture. However, a double-strand loop had a larger effect on increasing stiffness than using a single suture of a larger equivalent size. Looped suture repairs should be compared with standard techniques using a thicker single suture.

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