scholarly journals Reconstruct Flexor and Extensor tendon in Severe Hand Injury Using Allogenic tendon: A Retrospective study

2019 ◽  
Author(s):  
Gu Heng Wang ◽  
Tian Mao ◽  
Shu Guo Xing ◽  
Ya Lan Chen ◽  
Yu Xuan Zhang ◽  
...  
Keyword(s):  
T Cell ◽  
Grip Strength ◽  
Tendon Rupture ◽  
Extensor Tendon ◽  
Hand Injury ◽  
Pinch Strength ◽  
Active Motion ◽  
Flexor Tendon Rupture ◽  
Total Active Motion

Abstract Background To evaluate the effective and safety of reconstruction of flexor and extensor tendon in hand using allogenic tendon with 2- to 7.6-year fellow-up. Methods Between August 2007 and July 2014, we performed tendon allografts for 14 patients who suffered from severe hand injury with 2 or more tendon defects. 10 patients have been followed-up, 6 cases of flexor tendon rupture with defect, 3 cases of extensor tendon rupture with defect, 1 case with flexor and extensor tendon rupture with defect. Tendon allografts were used to repair tendon defects in order to reconstruct the function of flexion or extension. At the final follow-up visit, the total active motion (TAM), grip strength, pinch strength, DASH and the degree of satisfaction were measured. The WBC, C-reactive protein (CRP), Erythrocyte sedimentation rate (ESR), Total T cell and CD4+T/CD8+T were measured to evaluate the response related to immune and infection. Results The average follow-up period was 50.0 months (range 24-82 months). The mean motion of TAM was 129.9°(rang 12-259°), pinch strength was 0.76Kg (rang 0-4.5Kg), grip strength was 18.67Kg (rang 4-46Kg), the score of DASH was 14.25 (rang 3.3-30.8), 7 patients were satisfied and 3 patients were partially satisfied with the results. The results of WBC, CRP, ESR, Total T cell and CD4+ T/CD8+ T were mostly in normal field. Conclusion In severe hand injuries with multiple tendon defects, reconstruction of flexor and extensor tendon in hand using allogenic tendon is an effective and safe treatment.

scholarly journals Functional reconstruction of severe hand injuries using allogeneic tendons: a retrospective study

2020 ◽  
Vol 48 (10) ◽  
pp. 030006052095503
Author(s):  
Gu Heng Wang ◽  
Tian Mao ◽  
Shu Guo Xing ◽  
Ya Lan Chen ◽  
Yu Xuan Zhang ◽  
...  
Keyword(s):  
Cell Count ◽  
Grip Strength ◽  
Hand Function ◽  
Hand Injuries ◽  
Pinch Strength ◽  
Dash Score ◽  
Active Motion ◽  
Functional Reconstruction ◽  
Total Active Motion

Objective To evaluate the effectiveness and safety of allogeneic tendons for functional reconstruction of severe hand injuries. Methods From August 2007 to July 2014, we performed functional reconstruction with tendon allografts for severe hand injuries affecting two or more tendons. At the final follow-up, we assessed total active motion (TAM); pincer pinch strength; grip strength; Disabilities of the Arm, Shoulder, and Hand (DASH) score; degree of satisfaction; and adhesion. We measured the white blood cell count, C-reactive protein concentration, erythrocyte sedimentation rate, total T-cell count, and CD4+T/CD8+T ratio to evaluate the immune response and check for infection. Results Ten patients received 26 allogeneic tendons to reconstruct hand function. The average follow-up period was 50.0 months (range, 24–82 months). The TAM was 126.4° (12°–253°), pincer pinch strength was 0.83 kg (0–4.5 kg), and grip strength was 13.69 kg (4–41.5 kg). The DASH score was 14.25 (3.3–30.8), and seven and three patients were satisfied and partially satisfied, respectively. One patient developed tendon adhesion. All immune and infectious parameters were within the reference range. Conclusion Functional reconstruction using allogeneic tendons for severe hand injuries with multiple tendon defects was effective and safe; however, more research is needed.

scholarly journals Intramedullary Screws versus Kirschner Wires for Metacarpal Fixation, Functional, and Patient-Related Outcomes

2018 ◽  
Vol 04 (01) ◽  
pp. e29-e33 ◽  
Author(s):  
Jose Couceiro ◽  
Higinio Ayala ◽  
Manuel Sanchez ◽  
Maria De la Red ◽  
Olga Velez ◽  
...  
Keyword(s):  
Return To Work ◽  
Grip Strength ◽  
Kirschner Wire ◽  
Kirschner Wires ◽  
Active Motion ◽  
Contralateral Hand ◽  
Total Active Motion ◽  
Quick Dash ◽  
Dash Questionnaire

Purpose The purpose of our study is to compare the intramedullary fixation of metacarpal fractures with cannulated headless screws and antegrade Kirschner wires in terms of final total active motion, grip strength, patient-related outcomes, need for casting, and return to work times. Methods The authors performed a retrospective review of the hospital records. Thirty fractures were included in the study, 19 in the screw fixation group, and 11 in the Kirschner wire group. Grip strength, and total active motion, was measured at the latest follow-up for both the injured and contralateral hand. Pain was measured on the visual analog scale. Patients were requested to fill a Quick disabilities of the arm and hand score (DASH) questionnaire at the latest follow-up. Satisfaction was measured on a scale from 0 to 10. The time to return to work was quantified from the accident to the point when the patient was back to active duty. Postoperative casting time was also quantified. Results The authors did not find any differences between the two groups in total active motion, grip strength, pain, satisfaction, or Quick DASH scores. We did find a difference in the return to work and casting times; these appeared to be shorter in the screw group. Conclusion Due to the small number of cases, we have been unable to clearly conclude that there were any benefits in the application of one particular technique when compared with the other.

scholarly journals Dual Antegrade Intramedullary Headless Screw Fixation for Treatment of Unstable Proximal Phalanx Fractures

Hand ◽  
2018 ◽  
Vol 14 (4) ◽  
pp. 494-499 ◽  
Author(s):  
Michael P. Gaspar ◽  
Shiv D. Gandhi ◽  
Randall W. Culp ◽  
Patrick M. Kane
Keyword(s):  
Grip Strength ◽  
Proximal Phalanx ◽  
Retrospective Chart Review ◽  
Active Motion ◽  
Minimally Invasive Surgical ◽  
Number Of Patients ◽  
Total Active Motion ◽  
Minimally Invasive Surgical Treatment ◽  
Study Inclusion

Background: Although intramedullary headless screw (IMHS) fixation is a promising minimally invasive surgical treatment option for unstable proximal phalanx fractures, a single IMHS may provide inadequate fixation for certain fracture patterns. The purpose of this study was to evaluate the short-term clinical outcomes in a pilot series of patients with proximal phalanx fractures treated with dual antegrade IMHS fixation. Methods: We performed a retrospective chart review of proximal phalanx fractures treated with dual antegrade IMHS fixation with a minimum 1 year of follow-up. Demographic information including patient age, sex, occupation, workers’ compensation status, mechanism of injury, hand dominance, and injured digit were obtained. Postoperative outcomes measured included range of motion, grip strength, Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) outcome scores, return to full-duty work interval, and complications. Results: Ten fractures in 10 patients (4 male, 6 female) satisfied study inclusion. The mean age of patients was 39 years (range, 20-62), and average follow-up duration was 84 weeks (range, 61-106). Final postoperative total active motion was 258° (range, 245°-270°), mean grip strength was 97% (range, 84%-104%) of the uninjured side, and QuickDASH score was 3.9 (range, 0-13.6). No complications occurred, and no patients required additional intervention. Conclusions: Dual antegrade IMHS fixation of proximal phalanx fractures resulted in excellent postoperative motion, near-normal grip strength, positive self-reported patient outcomes, and no complications with follow-up of at least 1 year. Further study in a larger number of patients is warranted to determine if this promising technique is superior to other modes of fixation.

Arthroplasty Using Ball-and-Socket Type Ceramic Prosthesis for the Osteoarthritis of the Trapeziometacarpal Joint of the Thumb

2006 ◽  
Vol 309-311 ◽  
pp. 1363-1366
Author(s):  
Katsuji Suzuki ◽  
Kunio Shibata ◽  
Kanae Shigemori ◽  
Hirofusa Ichinose ◽  
Tohru Tanaka
Keyword(s):  
Grip Strength ◽  
High Density Polyethylene ◽  
Alumina Ceramic ◽  
High Density ◽  
Pinch Strength ◽  
Joint Function ◽  
Trapeziometacarpal Joint ◽  
Active Motion ◽  
Total Active Motion

Six patients underwent arthroplasty of the trapeziometacarpal joint of the thumb with our ball-and socket type ceramic prosthesis for the osteoarthritis of Eaton stage 3 or 4. Our prosthesis was made of alumina ceramic and high-density polyethylene. Pain and dislocation or subluxation of the trapeziometacarpal joint were found in all of the patients preoperatively and these symptoms were relieved completely after surgery. The % total active motion of the trapeziometacarpal joint and metacarpophalangeal + interphalangeal joints, the % grip strength and % pinch strength improved postoperatively. The trapeziometacarpal joint function according to Eaton’s criteria after surgery was excellent of 5 patients and good of 1 patient.

The Use of an Adipofascial Flap to Prevent Extensor Tendon Adhesions After Plating of the Proximal Phalanx of the Fingers: A Comparative Study

Hand ◽  
2020 ◽  
pp. 155894472096389
Author(s):  
Stefano Lucchina ◽  
Angelo D’Ambrosio ◽  
Cesare Fusetti ◽  
Marco Guidi
Keyword(s):  
Adverse Effects ◽  
Grip Strength ◽  
Proximal Phalanx ◽  
Extensor Tendon ◽  
Active Motion ◽  
Adipofascial Flap ◽  
Vas Score ◽  
Total Active Motion ◽  
Sample Characteristics ◽  
Dorsal Plating

Background: Extensor tendon adhesions occurring after proximal phalangeal (P1) fractures are not uncommon. A previous report described the use of an adipofascial flap (AFF) to prevent adhesions after dorsal plating of the P1. The purpose of the study is to examine the results of open reduction and internal fixation with the use of an AFF (F group) and without (N group, that is, no flap used) in a larger group of patients. Methods: A retrospective study involving a period of 11 years was conducted involving results of 21 unstable fractures of the P1 of the fingers in 18 patients. In all, 12 fingers were treated without any flap (N group) and 9 fingers were treated with the AFF (F group). For each patient, the total active motion (TAM) ratio, and the grip strength (Jamar) ratio were assessed, and adverse effects and the 10-point visual analogue scale (VAS) score were recorded. For statistical analysis, sample characteristics were described using mean ± standard deviation and median, and a Bayesian approach was used for inferential analysis. Results: In the F group, the TAM ratio (84% ± 13% vs 65% ± 17%) was higher with a lower rate of adverse effects (OR: 0.067, 95% CI, 0.0035-0.58,) and a lower VAS score with evidence of the positive effect of the AFF. The Jamar ratio was similar in the 2 groups (F group 80% ± 25% vs N group 79% ± 19%) with no associated effect of the AFF on grip strength. Conclusions: The AFF is a reliable tool to reduce adhesions between plates and the extensor apparatus of the P1 and may be useful to improve finger function after plating of P1 fractures. Type of study/LOE: Therapeutic, Retrospective, Level IV

K-Wire Fixation for Extraarticular Transverse/Short Oblique Fractures of the Shaft of the Middle Phalanx Associated with Extensor Tendon Injury

2008 ◽  
Vol 33 (5) ◽  
pp. 561-565 ◽  
Author(s):  
M. M. AL-QATTAN
Keyword(s):  
Extensor Tendon ◽  
Tendon Injury ◽  
Interphalangeal Joint ◽  
Middle Phalanx ◽  
Distal Interphalangeal Joint ◽  
Active Motion ◽  
Total Active Motion ◽  
Distal Interphalangeal ◽  
A Prospective Study

In a prospective study, 22 cases of extraarticular transverse/short oblique fractures of the shaft of the middle phalanx associated with extensor tendon injury had fixation of the fracture as well as immobilisation of the distal interphalangeal joint using a K-wire. Mobilisation of the proximal interphalangeal and metacarpophalangeal joints was started immediately after surgery. The wires were removed after 6 weeks. No post-operative complications were noted. At final follow-up (mean = 15 weeks, range = 12–24 weeks), 18 of 22 patients obtained excellent and good total active motion (TAM) scores. Stiffness was confined to the distal interphalangeal joint, and hence when the results were re-analysed for motion at that joint only, only 11 patients had excellent and good outcomes.

A Prospective, Controlled, Randomized Trial Comparing Early Active Extension with Passive Extension Using a Dynamic Splint in the Rehabilitation of Repaired Extensor Tendons

2002 ◽  
Vol 27 (3) ◽  
pp. 283-288 ◽  
Author(s):  
D. L. CHESTER ◽  
S. BEALE ◽  
L. BEVERIDGE ◽  
J. D. NANCARROW ◽  
O. G. TITLEY
Keyword(s):  
Controlled Trial ◽  
Extensor Tendon ◽  
Active Motion ◽  
Prospective Randomized Controlled Trial ◽  
Total Active Motion ◽  
Dynamic Splint ◽  
Group A ◽  
Active Mobilization ◽  
Group B

This prospective, randomized, controlled trial compared two methods of rehabilitating extensor tendon repairs in zones IV–VIII. Group A patients followed an early active mobilization regimen and Group B patients followed a dynamic splintage regimen. Data on 19 patients in Group A and 17 patients in Group B were collected at 4 weeks and at final follow-up (3 months median follow-up for both groups). Extension lag, flexion deficit and total active motion (TAM) were measured. At 4 weeks, patients in Group B had a better TAM (median 87%, range 56–102%) compared to patients in Group A (median 77%, range 52–97%). At final follow-up, there were no significant differences in the results of the two groups. There were no ruptures in either group.

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 ...

Results of Ray Resection and Amputation for Ring Avulsion Injuries at the Proximal Interphalangeal Joint

2003 ◽  
Vol 28 (6) ◽  
pp. 578-581 ◽  
Author(s):  
E. NUZUMLALI ◽  
E. ORHUN ◽  
K. ÖZTÜRK ◽  
S. CEPEL ◽  
S. POLATKAN
Keyword(s):  
Grip Strength ◽  
Ring Finger ◽  
Functional Results ◽  
Proximal Interphalangeal Joint ◽  
Pinch Strength ◽  
Resection Group ◽  
The Mean ◽  
Ring Avulsion

We investigated the long-term functional results of ray resection (14 cases) and amputation (nine cases) for ring avulsion injuries of ring finger which could not be replanted or underwent failed replantation. The mean follow-up was 37 (range, 24–63) months in the ray resection group and 32 (range, 24–40) months in the amputation group. Grip strength, key pinch strength, chuck pinch strength, hand circumference and palmar volume were decreased in the ray resection group but only grip strength and pulp pinch strength were significantly decreased in the amputation group. These results suggest that ray resection should be avoided in patients with occupations that need strong key and chuck pinch functions.

Clinical and Ultrasonographic Results of Ultrasonographically Guided Percutaneous Radiofrequency Lesioning in the Treatment of Recalcitrant Lateral Epicondylitis

2011 ◽  
Vol 39 (11) ◽  
pp. 2429-2435 ◽  
Author(s):  
Cheng-Li Lin ◽  
Jung-Shun Lee ◽  
Wei-Ren Su ◽  
Li-Chieh Kuo ◽  
Ta-Wei Tai ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Grip Strength ◽  
Surgical Intervention ◽  
Current Trend ◽  
Case Series ◽  
Lateral Epicondylitis ◽  
Extensor Tendon ◽  
Level Of Evidence ◽  
Vas Score

Background: In patients with lateral epicondylitis recalcitrant to nonsurgical treatments, surgical intervention is considered. Despite the numerous therapies reported, the current trend of treatment places particular emphasis on minimally invasive techniques. Purpose: The authors present a newly developed minimally invasive procedure, ultrasonographically guided percutaneous radiofrequency thermal lesioning (RTL), and its clinical efficacy in treating recalcitrant lateral epicondylitis. Study Design: Case series: Level of evidence, 4. Methods: Thirty-four patients (35 elbows), with a mean age of 52.1 years (range, 35-65 years), suffered from symptomatic lateral epicondylitis for more than 6 months and had exhausted nonoperative therapies. They were treated with ultrasonographically guided RTL. Patients were followed up at least 6 months by physical examination and 12 months by interview. The intensity of pain was recorded with a visual analog scale (VAS) score. The functional outcome was evaluated using grip strength, the upper limb Disability of Arm, Shoulder and Hand (QuickDASH) outcome measure, and the Modified Mayo Clinic Performance Index (MMCPI) for the elbow. The ultrasonographic findings regarding the extensor tendon origin were recorded, as were the complications. Results: At the time of the 6-month follow-up, the average VAS score in resting (from 4.9 to 0.9), palpation (from 7.6 to 2.5), and grip (from 8.2 to 2.9) had improved significantly compared with the preoperative condition ( P < .01). The grip strength (from 20.6 to 27.0 kg) and QuickDASH score (from 54.3 to 21.0) had also improved significantly ( P < .01). The MMCPI score improved from “poor” to “excellent.” The ultrasonographic finding revealed that the thickness of the common extensor tendon origin did not change significantly. At the final follow-up (mean, 14.3 months; range, 12-21 months), the patients reported a 78% reduction in pain compared with the preoperative status. No major complications were noted in any patient. Conclusion: Ultrasonographically guided RTL for recalcitrant lateral epicondylitis was found to be a minimally invasive treatment with satisfactory results in this pilot investigation. This innovative method can be considered as an alternative treatment of recalcitrant lateral epicondylitis before further surgical intervention.

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