A study of the anatomy and repair strengths of porcine flexor and extensor tendons: are they appropriate experimental models?

2011 ◽  
Vol 36 (8) ◽  
pp. 663-669 ◽  
Author(s):  
W. F. Mao ◽  
Y. F. Wu ◽  
Y. L. Zhou ◽  
J. B. Tang
Keyword(s):  
Flexor Tendon ◽  
Tendon Repair ◽  
Extensor Tendon ◽  
Experimental Models ◽  
Extensor Tendons ◽  
Flexor Tendons

Although both porcine flexor and extensor tendons have been used in tendon repair research, no studies have specifically studied the anatomical differences and repair strengths in both types of tendons. We used 12 pig trotters to observe the anatomy of these tendons and compared the 2 mm gap and ultimate strengths of flexor and extensor tendons. There were four annular (A1, A2, A3, and A4) pulleys and one oblique pulley, which form a fibro-osseous tunnel for the flexor tendons, but the anatomy of the porcine extensor tendons was markedly different from the human flexor or extensor tendons. The diameter of flexor tendons was significantly greater than that of the extensors. The 2 mm gap and ultimate strengths of the flexor tendon with either two-strand or four-strand repairs were significantly greater than those of the extensor tendon. We conclude that the porcine flexor tendon systems are similar to those in the human, but the extensor tendons are not similar to either the flexor or extensor tendons in humans. Flexor and extensor tendons have different repair strengths which should be taken into account when interpreting findings from investigations using these tendons.

Tendon Entrapment in Distal Radius Fractures

2009 ◽  
Vol 34 (4) ◽  
pp. 479-482 ◽  
Author(s):  
M. OKAZAKI ◽  
K. TAZAKI ◽  
T. NAKAMURA ◽  
Y. TOYAMA ◽  
K. SATO
Keyword(s):  
Clinical Features ◽  
Distal Radius ◽  
Flexor Tendon ◽  
Extensor Tendon ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Extensor Tendons ◽  
Epiphyseal Fracture ◽  
Tendon Entrapment

We retrospectively defined the rate and clinical features of tendon entrapment in 693 consecutive patients with 701 distal radius fractures treated in a single hospital. Eight extensor tendons and one flexor tendon were entrapped. All fractures with extensor tendon entrapment were palmarly displaced (Smith type) or epiphyseal. Flexor tendon entrapment was seen in dorsally angulated (Colles type) epiphyseal fracture. The rate of tendon entrapment in acute distal radius fractures was 1.3%. Extensor tendon entrapment in palmarly displaced fractures is more common.

Tendons

2011 ◽  
Author(s):  
David Warwick ◽  
Roderick Dunn ◽  
Erman Melikyan ◽  
Jane Vadher
Keyword(s):  
Tendon Rupture ◽  
Flexor Tendon ◽  
Tendon Repair ◽  
Tendon Healing ◽  
Extensor Tendon ◽  
Suture Techniques ◽  
Flexor Tendon Repair ◽  
Tendon Suture ◽  
Anatomy And Physiology ◽  
Flexor Tendon Rupture

Anatomy and physiology 392Tendon healing 394Flexor tendon anatomy 396Flexor tendon zones of injury 400Flexor tendon suture techniques 402Flexor tendon repair 404Closed flexor tendon rupture 410Flexor tenolysis 412Flexor tendon reconstruction 414Extensor tendon anatomy 418Extensor tendon repair ...

THE LONG GRAFT IN FLEXOR TENDON REPAIR — A 30-YEAR EXPERIENCE

Hand Surgery ◽  
1996 ◽  
Vol 01 (02) ◽  
pp. 141-146
Author(s):  
Ivan Matev
Keyword(s):  
Flexor Tendon ◽  
Tendon Repair ◽  
Flexor Tendon Repair ◽  
Flexor Tendons ◽  
Grafting Procedure

The author’s 30 years experience with long grafting procedure is presented and the essentials of the technique are outlined. When both flexor tendons are cut in Zone 2, secondary repair using long graft gives the possibility of better results than the conventional tendon grafting, when scarring exists in the palm.

A Comparison of Results of Extensor Tendon Repair Followed by Early Controlled Mobilisation Versus Static Immobilisation

1989 ◽  
Vol 14 (1) ◽  
pp. 18-20 ◽  
Author(s):  
J. A. Chow ◽  
S. Dovelle ◽  
L. J. Thomes ◽  
P. K. Ho ◽  
J. Saldana
Keyword(s):  
Tendon Repair ◽  
Extensor Tendon ◽  
Functional Results ◽  
Consecutive Series ◽  
Extensor Tendons ◽  
Dynamic Splinting ◽  
Tendon Surgery ◽  
Tendon Ruptures ◽  
Controlled Motion ◽  
Extensor Lag

To compare the functional results of early controlled mobilisation and static immobilisation following repair of extensor tendons, we conducted a comparative study between two centres. In one, a consecutive series of tenorrhaphy patients was treated post-operatively by the dynamic splinting technique. In the other, a consecutive group was treated by static splinting. All patients treated by dynamic splinting were graded excellent within six weeks following surgery; no tendon ruptures occurred and no secondary corrective tendon surgery was required. After static splinting, 40% were graded excellent, 31% good, 29% fair, and none poor; six fingers treated by static splintage subsequently required tenolysis. Following surgical repair of extensor tendons of the hand, patients treated by early controlled motion regain better flexion function in terms of grip strength and pulp-to-palm distance. Dynamic splinting is a more effective technique than static splinting in the prevention of extensor lag.

Primary Repair Of Flexor Tendons In The Hand Without Immobilisation – Preliminary Report

HAND ◽  
1978 ◽  
Vol os-10 (1) ◽  
pp. 37-47 ◽  
Author(s):  
Hilton Becker
Keyword(s):  
Blood Supply ◽  
Preliminary Report ◽  
Suture Material ◽  
Flexor Tendon ◽  
Primary Repair ◽  
Tendon Repair ◽  
Gap Formation ◽  
Flexor Tendon Repair ◽  
New Approach ◽  
Flexor Tendons

summary A new approach to the problem of flexor tendon repair within the fibro-osseous canal is presented. Using a technique of bevelling the tendon ends and suturing with a fine suture material, under magnification, a sufficiently strong junction is obtained, which enables immediate active mobilisation without strangulation of the blood supply. The junction can resist gap formation up to tensions of 4 Kg. It is postulated that under these conditions tendon nutrition is minimally interfered with, adhesions do not form, and the tendon heals by its own intrinsic healing ability.

The Mechanical Properties of Human Flexor Tendons in Relation to Artificial Tendons

1985 ◽  
Vol 10 (3) ◽  
pp. 331-336
Author(s):  
D. J. PRING ◽  
A. A. AMIS ◽  
R. R. H. COOMBS
Keyword(s):  
Mechanical Properties ◽  
Literature Search ◽  
Flexor Tendon ◽  
Tendon Repair ◽  
Middle Finger ◽  
Attractive Alternative ◽  
Published Data ◽  
Flexor Tendons ◽  
Human Finger ◽  
Sufficient Strength

The continuation of an unacceptable failure rate with tendon repair or grafting procedures, largely due to adhesions, suggested that an artificial flexor tendon could be an attractive alternative. A literature search found no published data of the mechanical properties of fresh human finger flexor tendons, so a study of the strength and extensibility of 153 tendons was carried out. The bone insertion strength of twenty middle finger tendons was also examined. The results showed that an artificial tendon should have a strength of approximately 1500N, and that it should extend 13% at that load, an elongation of 26mm for a tendon 200mm long. The insertion strength was less than a half of the tendon strength. This data will allow an artificial flexor tendon to be designed with sufficient strength and the correct elastic properties to allow its function to integrate reliably with natural tendons in adjacent fingers.

Flexor tendon injuries in the child

2013 ◽  
Vol 39 (1) ◽  
pp. 46-53 ◽  
Author(s):  
M. M. Al-Qattan
Keyword(s):  
Flexor Tendon ◽  
Tendon Repair ◽  
Tendon Injuries ◽  
Skin Closure ◽  
Two Stage ◽  
Flexor Tendon Repair ◽  
Technical Aspects ◽  
Tendon Reconstruction ◽  
Flexor Tendons ◽  
Flexor Tendon Injuries

This review aims to highlight the differences in the management of flexor tendon injuries between children and adults. These include differences in epidemiology, anatomy, classification, diagnosis, incisions and skin closure, the size of the flexor tendons, technical aspects of zones I and II repairs, core suture purchase length, rehabilitation, results, and complications of primary flexor tendon repair. Finally, one- versus two-stage flexor tendon reconstruction in children is reviewed.

A Comparison of Two Monofilament Suture Materials for Repair of Partial Flexor Tendon Lacerations: A Controlled In-vitro Study

2017 ◽  
Vol 22 (01) ◽  
pp. 18-22
Author(s):  
Abhinav Gulihar ◽  
Thomas Whitehead-Clarke ◽  
Ladan Hajipour ◽  
Joseph J. Dias
Keyword(s):  
Surgical Repair ◽  
Flexor Tendon ◽  
Tendon Repair ◽  
In Vitro Study ◽  
Suture Repair ◽  
Suture Materials ◽  
Flexor Tendons ◽  
Before And After ◽  
Materials Used

Background: Surgical repair is advocated for flexor tendon lacerations deeper than 70%. Repair can be undertaken with different suturing techniques and using different materials. Different materials used for tendon repair will have a different gliding resistance (GR) at the joint. Previous studies have compared strength of repair and gliding resistance for various braided suture materials and for 100% laceration of flexor tendons. We directly compare the GR of two monofilament sutures when used for a peripheral running suture repair of partially lacerated tendons. Methods: Sixteen flexor tendons and A2 pulleys were harvested from Turkey feet. They were prepared, partially lacerated to 50% depth, and then repaired with a core suture (modified Kessler technique with 4-0 Ethibond) as well as an additional superficial running suture of either 6-0 Prolene or Nylon (half randomised to each). Gliding resistance was measured for all tendons before and after repair, at different flexion angles (40 and 60 degrees) and for different loads (2N and 4N). Results: After surgical repair, gliding resistance was increased for all tendons (P < 0.01). The tendons repaired with Prolene had a higher mean gliding resistance than those repaired with Nylon (P = 0.02). Increased flexion angle and load amplified the gliding resistance (both P < 0.01). Conclusions: 6-0 Nylon was associated with a lower gliding resistance than 6-0 Prolene but the minor differences bare unknown clinical significance.

Histogenesis and Morphology of the Flexor Tendon Pulley System in the Human Embryonic Hand

2000 ◽  
Vol 25 (2) ◽  
pp. 175-179 ◽  
Author(s):  
M. C. SBERNARDORI ◽  
G. FENU ◽  
A. PIRINO ◽  
C. FABBRICIANI ◽  
A. MONTELLA
Keyword(s):  
Electron Microscope ◽  
Flexor Tendon ◽  
Middle Layer ◽  
Tendon Sheath ◽  
Pulley System ◽  
Outermost Layer ◽  
Extensor Tendons ◽  
Flexor Tendons ◽  
Mesenchymal Tissue

The number, position, structural and ultrastructural features of the flexor tendon pulley system in six human embryonic hands, aged from 6 to 12 weeks, were studied by light and electron microscope. The pulley system can be recognized from the ninth week; later, at 12 weeks, the structures are easily identified around the flexor tendon in positions closely correlated to those found during post-natal growth and in the adult hand. Structurally and ultrastructurally the pulleys are not simply thickened portions of the sheath. They are formed by three layers: an inner layer, one or two cells thick, probably representing a parietal synovial tendon sheath; a middle layer formed by collagen bundles and fibroblasts whose direction is mainly perpendicular to the underlying phalanx; and an outermost layer consisting of mesenchymal tissue with numerous vessels which extends dorsally in an identical layer, forming a ring that includes flexor and extensor tendons and the cartilaginous model of the phalanx. The pulley does not have a semicircular shape but a much more complicated one, owing to the middle layer which in part runs dorsally and in part ventrally, under the flexor tendons.

Controlled Active Motion Following Primary Flexor Tendon Repair: A Prospective Study Over 9 Years

1998 ◽  
Vol 23 (3) ◽  
pp. 344-349 ◽  
Author(s):  
C. K. KITSIS ◽  
P. J. F. WADE ◽  
S. J. KRIKLER ◽  
N. K. PARSONS ◽  
L. K. NICHOLLS
Keyword(s):  
Prospective Study ◽  
Flexor Tendon ◽  
Tendon Repair ◽  
High Strength ◽  
Suture Technique ◽  
Flexor Tendon Repair ◽  
Active Motion ◽  
Tendon Suture ◽  
Flexor Tendons ◽  
A Prospective Study

One hundred and thirty patients with 339 divided flexor tendons affecting 208 fingers were studied prospectively between 1988 and 1996, to assess a regime of primary flexor tendon suture and active postoperative motion, combined with a modified Kleinert dynamic traction splint. The tendon suture technique used was a high-strength multistrand technique using a modified Kessler core and a Halsted peripheral stitch. The results were influenced by the zone in which the tendon was divided, by the physiotherapy and to a lesser extent by the grade of surgeon operating. Overall results by Strickland criteria were 92% excellent or good, 7% fair and 1% poor. There were 43 complications in 31 patients including five zone 2 ruptures (5.7%) and one further rupture in zone 5. This method of flexor tendon repair requires good physiotherapy and splint-making capability but gives good results with minimal need for further surgery.

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