Flexor Tendon Retrieval in Zone I and II

Karbalaeikhani, Ali; Yavari, Masoud

doi:10.1097/bth.0b013e3182388561

Cited by 3 publications

(3 citation statements)

References 14 publications

(9 reference statements)

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“…Karbalaeikhani and Yavari 34 used a long loop of nylon suture to connect the proximal stump that was left in situ to the feeding tube. The tube is delivered distally, pulling on the tendon and retrieving it distally as well.…”

Section: Resultsmentioning

confidence: 99%

Techniques for Retrieval of Lacerated Flexor Tendons: A Scoping Review

et al. 2022

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Introduction: Flexor tendon laceration is often followed by retraction of the proximal stump. The goals of this review were to describe the myriad of proximal stump retrieval surgical techniques and where available to provide the clinical evidence associated with each. Methods: A Medline and Web of Science search was performed to identify any publication whose primary purpose was to describe a tendon retrieval technique. The techniques were assigned to 8 groups. Clinical outcomes, where reported, and advantages and disadvantages of the technique as reported by the authors of the articles were analyzed. Results: Eight-hundred and forty-one publications complied with the search terms, and 33 articles were included in the current analysis. Only 2 of these articles were randomized controlled trials, and they were of low quality. Conclusion: There is no high-quality evidence to allow quantitative comparison of tendon retrieval techniques. An incremental approach can be recommended based on the qualitative review. After failed atraumatic attempts to retrieve the tendon by milking, retrieval should be done through proximal incision at the A1 pulley level, preferably without pulling the tendon out of the wound. When available, using an endoscope to retrieve the tendon appears to be a promising alternative.

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Section: Resultsmentioning

confidence: 99%

Techniques for Retrieval of Lacerated Flexor Tendons: A Scoping Review

et al. 2022

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“…Agreed with the current evidence, in this study, most respondents (85%) supported atraumatic tendon retrieval, and reported a variety of retrieval techniques. Recent development of flexor tendon retrieval techniques advocated the use of sutures, a flexible tube and a proximal palmar incision, in which the tendon stump was connected to the flexible tube and successfully retrieved through the tendon sheath (5)(6)(7)(8). Most respondents (45%) mentioned the use of sutures and a flexible feeding tube, and some respondents (10%) also mentioned the creation of an extra incision.…”

Section: Discussionmentioning

confidence: 99%

“…Despite a wealth of research in the field, management of hand flexor tendon injury remains inconsistent in approaches and outcomes (3). Current evidence revealed several beneficial development and change in practice in the field, including the use of wideawake local anesthesia no tourniquet (WALANT) technique (4), updated methods of retrieving the retracted tendon stump (5)(6)(7)(8), change in tendon repair approaches (9), the use of early active mobilization in post-surgery rehabilitation (10).…”

Section: Introductionmentioning

confidence: 99%

Current clinical opinion on surgical approaches and rehabilitation of hand flexor tendon injury—a questionnaire study

Xue,

Wong,

Imere

et al. 2024

Front. Med. Technol.

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The management of flexor tendon injury has seen many iterations over the years, but more substantial innovations in practice have been sadly lacking. The aim of this study was to investigate the current practice of flexor tendon injury management, and variation in practice from the previous reports, most troublesome complications, and whether there was a clinical interest in potential innovative tendon repair technologies. An online survey was distributed via the British Society for Surgery of the Hand (BSSH) and a total of 132 responses were collected anonymously. Results showed that although most surgeons followed the current medical recommendation based on the literature, a significant number of surgeons still employed more conventional treatments in clinic, such as general anesthesia, ineffective tendon retrieval techniques, and passive rehabilitation. Complications including adhesion formation and re-rupture remained persistent. The interest in new approaches such as use of minimally invasive instruments, biodegradable materials and additive manufactured devices was not strong, however the surgeons were potentially open to more effective and economic solutions.

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