scholarly journals Comparison of step-cut and Pulvertaft attachment for flexor tendon graft: a biomechanics evaluation in an in vitro canine model

2012 ◽  
Vol 37 (9) ◽  
pp. 848-854 ◽  
Author(s):  
T. Hashimoto ◽  
A. R. Thoreson ◽  
K.-N. An ◽  
P. C. Amadio ◽  
C. Zhao
Keyword(s):  
Ultimate Load ◽  
Flexor Tendon ◽  
Canine Model ◽  
Tendon Graft ◽  
Flexor Digitorum Profundus ◽  
Load To Failure ◽  
Tendon Grafts ◽  
Flexor Digitorum ◽  
Flexor Tendon Graft

The purpose of this study was to compare two different methods of joining tendons of similar and dissimilar sizes between recipient and donor tendons for flexor tendon grafts. Flexor digitorum profundus (FDP) and peroneus longus (PL) canine tendons were harvested and divided into four groups. The repair technique we compared was a step-cut (SC) suture and a Pulvertaft weave (PW). FDP tendons were significantly larger in diameter than PL tendons ( p < 0.05). The volume of the SC repairs using either FDP or PL tendon as a graft was significantly smaller than PW repairs ( p < 0.05). The ultimate load to failure and repair stiffness in FDP graft tendons significantly increased compared with the PL graft tendons ( p < 0.05). The SC suture can be used as an alternative to the PW, with similar strength and less bulk for repairs using graft tendons of similar diameter. Surgeons should be aware of the effect of graft tendon size and repair method on strength and bulk when performing flexor tendon grafts.

Comparison of a multifilament stainless steel suture with FiberWire for flexor tendon repairs — an in vitro biomechanical study

2012 ◽  
Vol 38 (4) ◽  
pp. 418-423 ◽  
Author(s):  
E. McDonald ◽  
J. A. Gordon ◽  
J. M. Buckley ◽  
L. Gordon
Keyword(s):  
Mechanical Properties ◽  
Stainless Steel ◽  
Ultimate Load ◽  
Flexor Tendon ◽  
Biomechanical Study ◽  
Flexor Digitorum Profundus ◽  
Human Cadaver ◽  
Mode Of Failure ◽  
Flexor Digitorum

Our goal was to investigate and compare the mechanical properties of multifilament stainless steel suture (MFSS) and polyethylene multi-filament core FiberWire in flexor tendon repairs. Flexor digitorum profundus tendons were repaired in human cadaver hands with either a 4-strand cruciate cross-lock repair or 6-strand modified Savage repair using 4-0 and 3-0 multifilament stainless steel or FiberWire. The multifilament stainless steel repairs were as strong as those performed with FiberWire in terms of ultimate load and load at 2 mm gap. This study suggests that MFSS provides as strong a repair as FiberWire. The mode of failure of the MFSS occurred by the suture pulling through the tendon, which suggests an advantage in terms of suture strength.

The Length Of Flexor Tendon Grafts

HAND ◽  
1978 ◽  
Vol os-10 (1) ◽  
pp. 48-51 ◽  
Author(s):  
B. J. Mayou ◽  
S. H. Harrison
Keyword(s):  
Flexor Tendon ◽  
Standard Technique ◽  
Tendon Graft ◽  
Flexor Digitorum Profundus ◽  
Lumbrical Muscle ◽  
Tendon Grafts ◽  
Flexor Digitorum ◽  
Flexor Digitorum Profundus Tendon

Summary The distance between the origin of the lumbrical muscle and the insertion of the flexor digitorum profundus tendon was measured at surgery in forty-eight patients. It was found that this distance was predictable and could be estimated without measurement prior to operation. A standard technique of flexor tendon grafting is described where this distance equals the length of the tendon graft.

Flexor Tendon Repair Using a Stainless Steel Internal Anchor

1998 ◽  
Vol 23 (1) ◽  
pp. 37-40 ◽  
Author(s):  
L. GORDON ◽  
M. TOLAR ◽  
K. T. VENKATESWARA RAO ◽  
R. O. RITCHIE ◽  
S. RABINOWITZ ◽  
...  
Keyword(s):  
Tensile Strength ◽  
Stainless Steel ◽  
Flexor Tendon ◽  
Tendon Repair ◽  
Flexor Digitorum Profundus ◽  
Flexor Tendon Repair ◽  
Active Flexion ◽  
Active Range Of Motion ◽  
Flexor Digitorum

We have developed a stainless steel internal tendon anchor that is used to strengthen a tendon repair. This study tested its use in vitro to produce a repair that can withstand the tensile strength demands of early active flexion. Fresh human cadaver flexor digitorum profundus tendons were harvested, divided, and then repaired using four different techniques: Kessler, Becker or Savage stitches, or the internal tendon anchor. The internal splint repairs demonstrated a 99–270% increase in mean maximal linear tensile strength and a 49–240% increase in mean ultimate tensile strength over the other repairs. It is hoped that this newly developed internal anchor will provide a repair that will be strong enough to allow immediate active range of motion.

FLEXOR DIGITORUM PROFUNDUS TENDON RUPTURE ASSOCIATED WITH DISTAL RADIUS FRACTURE MALUNION: A CASE REPORT

Hand Surgery ◽  
2009 ◽  
Vol 14 (01) ◽  
pp. 35-38 ◽  
Author(s):  
Takayuki Ishii ◽  
Masayoshi Ikeda ◽  
Yuka Kobayashi ◽  
Joji Mochida ◽  
Yoshinori Oka
Keyword(s):  
Distal Radius Fracture ◽  
Distal Radius ◽  
Tendon Rupture ◽  
Flexor Tendon ◽  
Corrective Osteotomy ◽  
Tendon Graft ◽  
Radius Fracture ◽  
Flexor Digitorum Profundus ◽  
Flexor Tendon Rupture ◽  
Flexor Digitorum

We present a case of subcutaneous flexor tendon rupture of the index finger following malunion of a distal radius fracture. The cause of the tendon rupture was mechanical attrition due to a bony prominence at the palmar joint rim in the distal radius due to malunion. Corrective osteotomy and the Sauvé-Kapandji procedure were carried out for the wrist pain and forearm rotation disability and a tendon graft was carried out for the flexor tendon rupture. Recovery was satisfactory.

Simplifying four-strand flexor tendon repair using double-stranded suture: a comparative ex vivo study on tensile strength and bulking

2012 ◽  
Vol 37 (2) ◽  
pp. 101-108 ◽  
Author(s):  
T. H. Low ◽  
T. S. Ahmad ◽  
E. S. Ng
Keyword(s):  
Tensile Strength ◽  
Flexor Tendon ◽  
Ex Vivo ◽  
Tendon Repair ◽  
Flexor Digitorum Profundus ◽  
Flexor Tendon Repair ◽  
Significant Difference ◽  
Load To Failure ◽  
Fresh Frozen ◽  
Flexor Digitorum

We have compared a simple four-strand flexor tendon repair, the single cross-stitch locked repair using a double-stranded suture (dsSCL) against two other four-strand repairs: the Pennington modified Kessler with double-stranded suture (dsPMK); and the cruciate cross-stitch locked repair with single-stranded suture (Modified Sandow). Thirty fresh frozen cadaveric flexor digitorum profundus tendons were transected and repaired with one of the core repair techniques using identical suture material and reinforced with identical peripheral sutures. Bulking at the repair site and tendon–suture junctions was measured. The tendons were subjected to linear load-to-failure testing. Results showed no significant difference in ultimate tensile strength between the Modified Sandow (36.8 N) and dsSCL (32.6 N) whereas the dsPMK was significantly weaker (26.8 N). There were no significant differences in 2 mm gap force, stiffness or bulk between the three repairs. We concluded that the simpler dsSCL repair is comparable to the modified Sandow repair in tensile strength, stiffness and bulking.

A New Technique of Attachment of Flexor Tendons to The Distal Phalanx without A Button Tie-Over

1996 ◽  
Vol 21 (5) ◽  
pp. 629-632 ◽  
Author(s):  
M. K. SOOD ◽  
D. ELLIOT
Keyword(s):  
Flexor Tendon ◽  
Distal Phalanx ◽  
New Technique ◽  
Flexor Digitorum Profundus ◽  
Flexor Tendons ◽  
Tendon Grafts ◽  
A New Technique ◽  
Flexor Digitorum ◽  
Flexor Digitorum Profundus Tendon

A new technique of attachment of the flexor digitorum profundus tendon and flexor tendon grafts to the distal phalanx, without using a button on the nail, is described and its use reported in 14 cases.

Flexor Tendon Graft Attachment: A Review of Methods and A Newly Modified Tendon Graft Attachment

2003 ◽  
Vol 28 (2) ◽  
pp. 116-120 ◽  
Author(s):  
S. WILSON ◽  
D. SAMMUT
Keyword(s):  
Flexor Tendon ◽  
Tendon Graft ◽  
Distal Phalanx ◽  
Minimal Trauma ◽  
Tendon Grafts ◽  
Flexor Tendon Graft

A review of the described methods of attachment of flexor tendon grafts to the distal phalanx is presented. The authors advocate the previously described method of attachment consisting of passage of the tendon graft through the pulp with anchorage to the nail. A new modification of this technique is presented, facilitating accurate dissection and placement of the graft with minimal trauma.

scholarly journals Intrasynovial Tendon Graft for Chronic Flexor Tendon Laceration of the Finger: A Case Report

2013 ◽  
Vol 7 (1) ◽  
pp. 282-285 ◽  
Author(s):  
Jun Sasaki ◽  
Toshiro Itsubo ◽  
Koichi Nakamura ◽  
Masanori Hayashi ◽  
Shigeharu Uchiyama ◽  
...  
Keyword(s):  
Flexor Tendon ◽  
Ring Finger ◽  
Tendon Graft ◽  
Normal Function ◽  
Flexor Digitorum Profundus ◽  
Postoperative Function ◽  
A2 Pulley ◽  
The Right ◽  
Flexor Digitorum ◽  
Tendon Laceration

We present the case of a patient with flexor digitorum profundus tendon laceration at the A2 pulley level caused by an injury to the base of the right ring finger by a knife. The patient was treated by flexor tendon reconstruction from the palm to the fingertip by using the left second toe flexor tendon as a graft, which improved the active range of motion. Further improvement was achieved by subsequent tenolysis, which eventually restored nearly normal function. Our experience with this case indicates that the intrasynovial tendon is a reasonable graft source for the synovial space in fingers and may enable restoration of excellent postoperative function.

scholarly journals A Silent Closed Rupture of the Flexor Digitorum Profundus on the Index Finger: An Unsolved Mystery

2021 ◽  
Vol 17 (2) ◽  
pp. 146-149
Author(s):  
Hyun-Dong Yeo ◽  
Na-Hyun Hwang ◽  
Seung-Ha Park ◽  
Byung-Il Lee ◽  
Eul-Sik Yoon ◽  
...  
Keyword(s):  
Tendon Rupture ◽  
Flexor Tendon ◽  
Index Finger ◽  
Tendon Graft ◽  
Flexor Digitorum Profundus ◽  
Left Index Finger ◽  
Two Stage ◽  
Closed Rupture ◽  
Flexor Tendon Rupture ◽  
Flexor Digitorum

We report the case of a patient who fully recovered from a closed flexor tendon rupture through a two-stage flexor tendon reconstruction using silicone rods, despite a considerable delay in treatment. A 17-year-old male patient visited our clinic with a sudden inability to flex his left index finger, although there were no signs of injury. Magnetic resonance imaging revealed an extensive rupture of the flexor digitorum profundus from the base of the distal phalanx to the proximal phalangeal joint of his left hand. After a two-stage tendon graft operation was performed, the patient regained full flexion of the index finger and was able to hold a fist without any limitations in range of motion. Complete rupture of tendons usually accompanies history of trauma or underlying tendon pathology. In our case, however, the tendon rupture occurred silently with no obvious underlying causes. It is important to recognize the signs to evaluate the underlying structures for appropriate management and treatment. Even with considerable delay, the patient may regain full function of the tendon.

AN ANALYSIS OF PARTIAL WIDTH FLEXOR TENDON GRAFT PREPARATION ON PORCINE MODELS: THE OPTIMAL SPLIT?

Hand Surgery ◽  
2010 ◽  
Vol 15 (02) ◽  
pp. 99-102
Author(s):  
Toby Colegate-Stone ◽  
Richard Allom ◽  
Adel Tavakkolizadeh ◽  
John Compson
Keyword(s):  
Suture Material ◽  
Flexor Tendon ◽  
Tendon Graft ◽  
Partial Width ◽  
Suture Materials ◽  
Average Force ◽  
Handling Characteristics ◽  
Tendon Grafts ◽  
Flexor Tendon Graft

Partial width tendon grafts are commonly used in upper limb reconstructive surgery. Different techniques are described to harvest the graft including a "cheese wire" technique to split the tendon along its fibres with a filament. However no study has looked at the best material for this purpose. Fresh flexor tendons from pigs' trotters were used to analyse the splitting qualities of 11 different suture materials. The qualities assessed were: whether the suture material was successful in splitting the tendon, the average force required to split the tendon and the resulting quality of the spilt tendon graft. Whilst wire sutures produced a high quality of graft, they were awkward to use as they necessitated handling with a holder due to the higher forces required to split the tendon. Fibrewire provided the best result with respect to graft quality and ease of method as it combined the cutting strength of wire with the handling characteristics of a braided suture.

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