In vivo flexor tendon forces generated during different rehabilitation exercises

Edsfeldt, Sara; Rempel, David; Kursa, Katarzyna; Diao, E; Lattanza, Lisa

doi:10.1177/1753193415591491

Cited by 43 publications

(33 citation statements)

References 41 publications

(51 reference statements)

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“…Two crossed wires were used for each sample. To evaluate the fixation stability and estimate a fatigue resistance of the FRAP fixation, cyclic loads relevant to rehabilitation exercises were applied on the fracture models with transverse and oblique fractures . Loads between 10 and 70 N were applied continuously for 1000 cycles under humid conditions.…”

Section: Resultsmentioning

confidence: 99%

High‐Performance Thiol–Ene Composites Unveil a New Era of Adhesives Suited for Bone Repair

Granskog

García‐Gallego

Kieseritzky

et al. 2018

Adv Funct Materials

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The use of adhesives for fracture fixation can revolutionize the surgical procedures toward more personalized bone repairs. However, there are still no commercially available adhesive solutions mainly due to the lack of biocompatibility, poor adhesive strength, or inadequate fixation protocols. Here, a surgically realizable adhesive system capitalizing on visible light thiol-ene coupling chemistry is presented. The adhesives are carefully designed and formulated from a novel class of chemical constituents influenced by dental resin composites and self-etch primers. Validation of the adhesive strength is conducted on wet bone substrates and accomplished via fiber-reinforced adhesive patch (FRAP) methodology. The results unravel, for the first time, on the promise of a thiol-ene adhesive with an unprecedented shear bond strength of 9.0 MPa and that surpasses, by 55%, the commercially available acrylate dental adhesive system Clearfil SE Bond of 5.8 MPa. Preclinical validation of FRAPs on rat femur fracture models details good adhesion to the bone throughout the healing process, and are found biocompatible not giving rise to any inflammatory response. Remarkably, the FRAPs are found to withstand loads up to 70 N for 1000 cycles on porcine metacarpal fractures outperforming clinically used K-wires and match metal plates and screw implants.

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Section: Resultsmentioning

confidence: 99%

High‐Performance Thiol–Ene Composites Unveil a New Era of Adhesives Suited for Bone Repair

Granskog

García‐Gallego

Kieseritzky

et al. 2018

Adv Funct Materials

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show abstract

“…Tendon excursion studies in cadavers have shown that as much as 9 cm arc of motion is required for a combined flexion of wrist and fingers, whereas just 2.5 cm of tendon excursion produces full digital flexion with the wrist in neutral. [55][56][57][58] An in vivo study by Edsfeldt and colleagues 59 analyzing forces generated during finger exercises corroborated with these studies demonstrating that "place and hold" and active finger flexion with the wrist in the neutral position or minimal tenodesis extension produced the lowest forces. Additionally, in vivo studies have revealed that active movements generate 1.0 to 2.0 mm per 10-degree of arc of motion, whereas passive exercises generated only 0.4 to 0.9 mm per 10-degree, likely associated with tendon buckling.…”

Section: Discussionmentioning

confidence: 69%

“…Therefore, combining SWM and active mid-range digit flexion, as previously suggested, has added benefit on the differential tendon excursion with minimal load on the healing tendons, corroborated by various tendon biomechanical studies. 3,4,25,35,38,59,62 Postsurgical resistance to the gliding of the tendons in a fibrosseous sheath dictates that mobilization of these tendons be advanced by using gradual increments of wrist synergistic motion and active finger flexion in the phase 1 and combination of wrist and digital flexion, wrist and digital extension progressively in phases 2 and 3, depending on the of tendon suturing technique. This method of mobilization enhances differential tendon motion in zone II and will hopefully prevent permanent loss of ROM due to adhesion formation.…”

Section: Discussionmentioning

confidence: 99%

Pathomechanics and Management of Secondary Complications Associated with Tendon Adhesions Following Flexor Tendon Repair in Zone II

2016

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Despite the number of rehabilitation strategies and guidelines developed to maximize the gliding amplitude of repaired tendons, secondary complications, such as decreased range of motion and stiffness associated with tendon adhesions, commonly arise. If left untreated, these early complications may lead to secondary pathomechanical changes resulting in fixed deformities and decreased function. Therefore, an appropriate treatment regimen must not only include strategies to maintain the integrity of the repaired tendon, but must also avoid secondary complications due to reduced gliding amplitude. This review presents a biomechanical analysis of the dynamics of tendon gliding following repair in zone II and rehabilitation strategies to minimize secondary complications related with tendon adhesions.

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“…For validation of the healthy tendon, several studies have been reviewed. Yang et al [25] and Tanaka et al [26] both tested this using tendons taken from fresh cadavers, whereas Kursa et al [27] and Edsfeldt et al [28] carried out testing during open carpal tunnel surgery. These studies all reported on loading forces during flexion.…”

Section: Discussionmentioning

confidence: 99%

A Finite Element Model for Trigger Finger

2020

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The aim of this study was to develop a finite element model to investigate the forces on tendons which ensue due to trigger finger. The model was used to simulate both flexor and extensor tendons within the index finger; two test cases were defined, simulating a “mildly” and “severely” affected tendon by applying constraints. The finger was simulated in three different directions: extension, abduction and hyper-extension. There was increased tension during hyper-extension, with tension in the mildly affected tendon increasing from 1.54 to 2.67 N. Furthermore, there was a consistent relationship between force and displacement, with a substantial change in the gradient of the force when the constraints of the condition were applied for all movements. The intention of this study is that the simulation framework is used to enable the in silico development of novel prosthetic devices to aid with treatment of trigger finger, given that, currently, the non-surgical first line of treatment is a splint.

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In vivo flexor tendon forces generated during different rehabilitation exercises

Abstract: III (controlled trial without randomization).

Cited by 43 publications

References 41 publications

High‐Performance Thiol–Ene Composites Unveil a New Era of Adhesives Suited for Bone Repair

High‐Performance Thiol–Ene Composites Unveil a New Era of Adhesives Suited for Bone Repair

Pathomechanics and Management of Secondary Complications Associated with Tendon Adhesions Following Flexor Tendon Repair in Zone II

A Finite Element Model for Trigger Finger

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