Tranexamic Acid Effect on Digit Function Following Primary Repair of Traumatic Digit Flexor Tendon Injuries

2019 ◽  
Author(s):  
Keyword(s):  
Tranexamic Acid ◽  
Flexor Tendon ◽  
Primary Repair ◽  
Tendon Injuries ◽  
Acid Effect ◽  
Flexor Tendon Injuries ◽  
Digit Function

Up to five-week delay in primary repair of Zone 2 flexor tendon injuries: outcomes and complications

2021 ◽  
pp. 175319342110244
Author(s):  
Giovanni Munz ◽  
Andrea Poggetti ◽  
Luca Cenci ◽  
Anna Rosa Rizzo ◽  
Marco Biondi ◽  
...  
Keyword(s):  
Flexor Tendon ◽  
Primary Repair ◽  
Early Mobilization ◽  
Exercise Programme ◽  
Tendon Injuries ◽  
Level Of Evidence ◽  
Active Motion ◽  
Active Flexion ◽  
Surgical Methods ◽  
Flexor Tendon Injuries

We report the outcomes of delayed primary repair of flexor tendons in Zone 2 in 31 fingers and thumb (28 patients) averaging 15 days (range 4–37) after injury in 2020. The delay was longer than usual due to the COVID-19 pandemic. The tendons were repaired with a 6-strand core suture (M-Tang method) or a double Tsuge suture and a peripheral suture. This was followed by an early, partial-range, active flexion exercise programme. Adhesions in four digits required tenolysis. These patients were not with longest delay. Outcomes of two improved after tenolysis. The other two patients declined further surgery. One finger flexor tendon ruptured in early active motion. This was re-repaired, and final outcome was good. Overall excellent and good results using the Tang criteria were in 27 out of 31 fingers and thumbs (87%). The time elapsed between the injury and surgery is not an important risk factor for a good outcome, rather it depends on proper surgical methods, the surgeon's experience and early mobilization, properly applied. Adhesions may occur, but they can be managed with tenolysis. Level of evidence: IV

Flexor tendon injuries

2011 ◽  
Author(s):  
Robert Savage
Keyword(s):  
Patient Care ◽  
Emergency Services ◽  
Flexor Tendon ◽  
Primary Repair ◽  
Tendon Injuries ◽  
Team Work ◽  
Secondary Surgery ◽  
Central Tenet ◽  
Flexor Tendon Injuries ◽  
Tendon Surgery

♦ Restoring continuity to the supple yet high tensile flexor tendon system presents a challenge unique in surgery. Although there is continuing debate about many details of technique, the central tenet of modern flexor tendon surgery is to repair and move the flexor tendons within a few days of injury♦ Knowledge and experience count for everything at all points of patient care beginning with accurate and timely diagnosis. Emergency services should be arranged to relocate these injuries to appropriately trained surgeons and team-work with specialist hand therapists is an essential part of today’s treatment♦ While all flexor tendon surgery is complicated, it is simplest in the newly injured and unscarred digit, and the results of the correctly rehabilitated primary repair appear to be the best attainable♦ However, occasions will arise when secondary surgery will be necessary and the appropriate skills must be learned.

scholarly journals Wide awake surgery for flexor tendon primary repair: A literature review

2020 ◽  
Author(s):  
Camillo Fulchignoni ◽  
Mario Alessandri Bonetti ◽  
Giuseppe Rovere ◽  
Antonio Ziranu ◽  
Giulio Maccauro ◽  
...  
Keyword(s):  
Local Anesthesia ◽  
Flexor Tendon ◽  
Primary Repair ◽  
Tendon Repair ◽  
Tendon Injuries ◽  
Awake Surgery ◽  
Cochrane Library ◽  
Surgical Approaches ◽  
Flexor Tendon Injuries ◽  
Wide Awake

Flexor tendon injuries are extremely challenging conditions to manage for hand surgeons. Over the last few years enormous progress has been made for the treatment of these lesions with new surgical approaches being performed. One of these is the wideawake local anesthesia no tourniquet (WALANT) technique, also known as Wide Awake Technique that allows tendon repair under local anesthesia, enabling the tendon to move actively during surgery. Dynamic movement of the tendon during surgery is crucial for the orthopedic surgeon in order to understand if the tendon has been correctly repaired before leaving the operatory table. An electronic literature research was carried out on Pubmed, Google Scholars and Cochrane Library using ((Flexor tendon injury) OR (flexor tendon) OR (injury muscle tendon) OR (flexor pollicis longus tendon) AND ((wide awake repair) OR (wide awake) OR (wide awake hand surgery))as search terms. Authors believe that WALANT is an enormous add-on in the management of patients with flexor tendon injuries mainly because it allows direct visualization of the repair during flexion and extension movement of the fingers and also because it avoids general anesthesia or brachial plexus being more cost effective. The aim of these review was therefore to sum up the evidences available so far on the wade awake technique as an emerging treatment for patients with flexor tendon injuries.

Improved Results in Zone 2 Flexor Tendon Injuries with a Modified Technique of Immediate Controlled Mobilization

1993 ◽  
Vol 18 (1) ◽  
pp. 26-30 ◽  
Author(s):  
L-E. KARLANDER ◽  
M. BERGGREN ◽  
M. LARSSON ◽  
G. SÖDERBERG ◽  
G. NYLANDER
Keyword(s):  
Flexor Tendon ◽  
Primary Repair ◽  
Rubber Band ◽  
Tendon Injuries ◽  
Modified Technique ◽  
Flexor Tendon Injuries

The results following primary and delayed primary repair in zone 2 flexor tendon injuries were evaluated in 85 fingers of 79 patients using immediate controlled mobilization post-operatively. In 31 patients a conventional Kleinert technique was used. In the remaining 48 patients a modified technique was used with rubber band traction to all fingers instead of only to the injured one. Also a shorter dorsal splint was used in order to secure extension of the PIP and DIP joints. The results were improved and the time of treatment was reduced.

scholarly journals Outcomes After Primary Repair and Staged Reconstruction of Zone I and II Flexor Tendon Injuries in Children

2019 ◽  
Vol 39 (5) ◽  
pp. 263-267 ◽  
Author(s):  
Samantha L. Piper ◽  
Lesley C. Wheeler ◽  
Janith K. Mills ◽  
Marybeth Ezaki ◽  
Scott N. Oishi
Keyword(s):  
Flexor Tendon ◽  
Primary Repair ◽  
Tendon Injuries ◽  
Flexor Tendon Injuries ◽  
Staged Reconstruction

Flexor Tendon Injuries: The Results of Primary Repair

1988 ◽  
Vol 13 (3) ◽  
pp. 269-272
Author(s):  
M. SINGER ◽  
S. MALOON
Keyword(s):  
Flexor Tendon ◽  
Primary Repair ◽  
Hand Surgery ◽  
Tendon Injury ◽  
Tendon Injuries ◽  
Flexor Digitorum Profundus ◽  
Flexor Tendon Injuries ◽  
No Man's Land ◽  
Flexor Pollicis Longus Tendon ◽  
Flexor Digitorum

This study is a critical analysis of results obtained following primary repair and post-operative controlled mobilisation of flexor tendon injuries which were treated by registrars with up to six months experience in hand surgery. 70 (55%) of 125 patients who underwent repair of a complete flexor digitorum profundus or flexor pollicis longus tendon injury during a 14-month period attended for review and these had a total of 140 injured digits. 93 (67%) were rated Lister’s standards as an “excellent” or “good” result. 39 (28%) occurred in “no man’s land” (Zone 2) and only 19 (49%) in this area were rated “excellent” or “good”. Isolated flexor digitorum superficialis tendon injuries have been excluded from this study, as have partial tendon injuries.

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