scholarly journals Four-Strand Core Suture Improves Flexor Tendon Repair Compared to Two-Strand Technique in a Rabbit Model

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Alice Wichelhaus ◽  
Sascha Tobias Beyersdoerfer ◽  
Brigitte Vollmar ◽  
Thomas Mittlmeier ◽  
Philip Gierer
Keyword(s):  
Suture Material ◽  
Flexor Tendon ◽  
Healing Process ◽  
Adhesion Formation ◽  
Rabbit Model ◽  
Tendon Repair ◽  
Initial Increase ◽  
Suture Repair ◽  
Flexor Tendon Repair ◽  
The Third

Introduction. This study was designed to investigate the influence of the amount of suture material on the formation of peritendinous adhesions of intrasynovial flexor tendon repairs.Materials and Methods. In 14 rabbits, the flexor tendons of the third and the fourth digit of the right hind leg were cut and repaired using a 2- or 4-strand core suture technique. The repaired tendons were harvested after three and eight weeks. The range of motion of the affected toes was measured and the tendons were processed histologically. The distance between the transected tendon ends, the changes in the peritendinous space, and cellular and extracellular inflammatory reaction were quantified by different staining.Results. A 4-strand core suture resulted in significantly less gap formation. The 2-strand core suture showed a tendency to less adhesion formation. Doubling of the intratendinous suture material was accompanied by an initial increase in leukocyte infiltration and showed a greater amount of formation of myofibroblasts. From the third to the eighth week after flexor tendon repair, both the cellular and the extracellular inflammation decreased significantly.Conclusion. A 4-strand core suture repair leads to a significantly better tendon healing process with less diastasis between the sutured tendon ends despite initially pronounced inflammatory response.

A Novel Flexor Tendon Repair Device: Biomechanical Testing in Cadaver Tendon and In-Vivo Verification Using a Rabbit Model

2013 ◽  
Author(s):  
Shawn P. Reese ◽  
Eric N. Kubiak
Keyword(s):  
Flexor Tendon ◽  
Biomechanical Testing ◽  
Rabbit Model ◽  
Tendon Repair ◽  
Flexor Digitorum Profundus ◽  
Suture Repair ◽  
Flexor Tendon Repair ◽  
Tissue Ischemia ◽  
Flexor Tendons

The digital flexor tendons of the hand, including the flexor digitorum profundus (FDP), are responsible for enabling finger flexion and gripping. Injuries involving a partial or complete laceration to the digital flexor tendons are common and associated with a high incidence of morbidity [1]. The current state of the art for flexor tendon repair is the use of two or more core sutures in combination with an epitendinous circumferential suture. There are inherent limitations to suture based methods, including a high level of skill required to perform the suture repair, increased surgical time and the tendency for sutures to strangulate the tissue (creating local tissue ischemia). Suture based repairs often result in sub-optimal clinical outcomes, with reported failure rates ranging from 4%–10% [2]. In order to address these limitations, a novel non-suture based repair device has been developed. The objectives of this study were twofold. The first objective was to determine the gapping strength of the device in cadaver FDP tendons so that comparisons could be made to values reported in the literature for suture based repairs. The second objective was to determine the in-vivo capability of the device to facilitate tendon repair, relative to a suture control, in a rabbit model at a five week time point.

THE EFFECT OF THERMAL PRECONDITIONING OF THE LIMB ON FLEXOR TENDON HEALING

2007 ◽  
Vol 32 (3) ◽  
pp. 289-295 ◽  
Author(s):  
C. HEALY ◽  
K. J. MULHALL ◽  
D. FITZ PATRICK ◽  
E. W. KAY ◽  
D. BOUCHIER-HAYES
Keyword(s):  
Heat Shock ◽  
Flexor Tendon ◽  
Adhesion Formation ◽  
Rabbit Model ◽  
Tendon Repair ◽  
Tendon Healing ◽  
Flexor Tendon Repair ◽  
Treatment Groups ◽  
Tendon Surgery ◽  
Thermal Preconditioning

Thermal preconditioning reduces inflammation by inducing cytoprotective heat shock proteins. We evaluated the role of limb thermal preconditioning in a rabbit model of flexor tendon repair. The treatment groups underwent limb preconditioning by elevating the limb temperature to 41.5 °C for 20 minutes. The animals were sacrificed three and six weeks after flexor tendon repair. Heat shock protein72 expression of the treated limb was measured at 18 hours. Macroscopic analysis demonstrated a significant decrease in adhesion formation in the three week treatment group. The inflammatory infiltrate was significantly reduced for both treatment groups. The difference in ultimate tensile strength was not significant. We conclude that thermal preconditioning of the limb before flexor tendon repair decreases inflammation and adhesion formation in a rabbit model and has the potential to improve clinical outcome of flexor tendon surgery.

The effect of a collagen-elastin matrix on adhesion formation after flexor tendon repair in a rabbit model

2016 ◽  
Vol 136 (7) ◽  
pp. 1021-1029 ◽  
Author(s):  
Dagmar Alice Wichelhaus ◽  
Sascha Tobias Beyersdoerfer ◽  
Philip Gierer ◽  
Brigitte Vollmar ◽  
Th. Mittlmeier
Keyword(s):  
Flexor Tendon ◽  
Adhesion Formation ◽  
Rabbit Model ◽  
Tendon Repair ◽  
Flexor Tendon Repair

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.

Factors Affecting the Strength of Flexor Tendon Repair

1992 ◽  
Vol 17 (5) ◽  
pp. 550-552 ◽  
Author(s):  
D. BHATIA ◽  
K. E. TANNER ◽  
W. BONFIELD ◽  
N. D. CITRON
Keyword(s):  
Cyclic Load ◽  
Suture Material ◽  
Flexor Tendon ◽  
Tendon Repair ◽  
Flexor Tendon Repair ◽  
Factors Affecting ◽  
Full Strength ◽  
Load Tests

The effects of different thicknesses and configurations of core sutures were studied in human cadaveric flexor tendon repairs. Both straight and cyclic load tests were employed. To exploit the full strength of 4/0 suture material, the Kessler repair using four locked single knots would seem to be appropriate.

Flexor tendon repair with a polytetrafluoroethylene (PTFE) suture material

2019 ◽  
Vol 139 (3) ◽  
pp. 429-434
Author(s):  
Elias Polykandriotis ◽  
Foued Besrour ◽  
Andreas Arkudas ◽  
Florian Ruppe ◽  
Katharina Zetzmann ◽  
...  
Keyword(s):  
Suture Material ◽  
Flexor Tendon ◽  
Tendon Repair ◽  
Flexor Tendon Repair

scholarly journals Tensile Strength of Flexor Tendon Repair Using Barbed Suture Material in a Dynamic Ex Vivo Model

2016 ◽  
Vol 04 (01) ◽  
pp. 16-20 ◽  
Author(s):  
Philip Zeplin ◽  
M. Henle ◽  
R. Zahn ◽  
R. Meffert ◽  
K. Schmidt
Keyword(s):  
Tensile Strength ◽  
Suture Material ◽  
Flexor Tendon ◽  
Ex Vivo ◽  
Tendon Repair ◽  
Barbed Suture ◽  
Ex Vivo Model ◽  
Flexor Tendon Repair

scholarly journals Systemic EP4 Inhibition Increases Adhesion Formation in a Murine Model of Flexor Tendon Repair

PLoS ONE ◽  
2015 ◽  
Vol 10 (8) ◽  
pp. e0136351 ◽  
Author(s):  
Michael B. Geary ◽  
Caitlin A. Orner ◽  
Fatima Bawany ◽  
Hani A. Awad ◽  
Warren C. Hammert ◽  
...  
Keyword(s):  
Murine Model ◽  
Flexor Tendon ◽  
Adhesion Formation ◽  
Tendon Repair ◽  
Flexor Tendon Repair

Digital Oedema, Adhesion Formation and Resistance to Digital Motion after Primary Flexor Tendon Repair

2008 ◽  
Vol 33 (6) ◽  
pp. 745-752 ◽  
Author(s):  
Y. CAO ◽  
C. H. CHEN ◽  
Y. F. WU ◽  
X. F. XU ◽  
R. G. XIE ◽  
...  
Keyword(s):  
Flexor Tendon ◽  
Subcutaneous Tissue ◽  
Adhesion Formation ◽  
Tendon Repair ◽  
Flexor Tendon Repair ◽  
Postoperative Changes ◽  
Three Stages

The development of digital oedema, adhesion formation, and resistance to digital motion at days 0, 3, 5, 7, 9 and 14 after primary flexor tendon repairs using 102 long toes of 51 Leghorn chickens was studied. Oedema presented as tissue swelling from days 3 to 7, which peaked at day 3. After day 7, oedema was manifest as hardening of subcutaneous tissue. The degree of digital swelling correlated with the resistance to tendon motion between days 3 and 7. At day 9, granulation tissues were observed around the tendon and loose adhesions were observed at day 14. Resistance to digital motion increased significantly from day 0 to day 3, but did not increase between days 3 and 9. The early postoperative changes appear to have three stages: initial (days 0–3, increasing resistance with development of oedema), delayed (days 4–7, higher resistance with continuing oedema) and late (after day 7–9, hardening of subcutaneous tissue with development of adhesions).

The Pathology of Flexor Tendon Repair

HAND ◽  
1979 ◽  
Vol os-11 (3) ◽  
pp. 233-242 ◽  
Author(s):  
Phillip Matthews
Keyword(s):  
Recent Work ◽  
Flexor Tendon ◽  
Adhesion Formation ◽  
Tendon Repair ◽  
Tendon Tissue ◽  
Flexor Tendon Repair ◽  
Long Time ◽  
The Subject ◽  
Methods Of Treatment

This paper discusses the problems of failure after tendon repair. For a long time the subject has been dominated by the problem of adhesion formation. Recent work has shown that this is not inevitable, and consideration of other factors, particularly the nutrition of tendon tissue is leading to the possibilities of other methods of treatment.

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