Results of heterodigital flexor digitorum profundus hemi-tendon transfer for 23 flexor tendon injuries in zones 1 or 2

Bommier, Aude; McGuire, Duncan; Boyer, Patrick; Rafee, A.; Razali, Sami; Oberlin, C.

doi:10.1177/1753193417737920

Cited by 5 publications

(3 citation statements)

References 20 publications

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“…The tensile strength of sutures is also an important aspect of tendon repair because it is the basis of a strong repair of the tendons that resists gapping or breakage at the repair site. [37][38][39][40][41][42][43][44] Lowstrength sutures easily lead to postoperative rupture and should always be avoided. [37][38][39][40][41][42][43][44] The tensile strengths of two modified sutures (Ethicon and PDS II) were tested with a mechanical testing instrument, and no significant change was found in tensile strengths.…”

Section: Discussionmentioning

confidence: 99%

“…[37][38][39][40][41][42][43][44] Lowstrength sutures easily lead to postoperative rupture and should always be avoided. [37][38][39][40][41][42][43][44] The tensile strengths of two modified sutures (Ethicon and PDS II) were tested with a mechanical testing instrument, and no significant change was found in tensile strengths. The results show that this modification method does not affect the mechanical properties of the sutures.…”

Section: Discussionmentioning

confidence: 99%

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Gene-Loaded Nanoparticle-Coated Sutures Provide Effective Gene Delivery to Enhance Tendon Healing

et al. 2019

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How to accelerate tendon healing remains a clinical challenge. In this study, a suture carrying nanoparticle/pEGFP-basic fibroblast growth factor (bFGF) and pEGFP-vascular endothelial growth factor A (VEGFA) complexes was developed to transfer the growth factor genes into injured tendon tissues to promote healing. Polydopamine-modified sutures can uniformly and tightly absorb nanoparticle/plasmid complexes. After tendon tissues were sutured, the nanoparticle/plasmid complexes still existed on the suture surface. Further, we found that the nanoparticle/plasmid complexes delivered into tendon tissues could diffuse from sutures to tendon tissues and effectively transfect genes into tendon cells, significantly increasing the expression of growth factors in tendon tissues. Finally, biomechanical tests showed that nanoparticle/pEGFP-bFGF and pEGFP-VEGFA complex-coated sutures could significantly increase the ultimate strengths of repaired tendons, especially at 4 weeks after operation. Two kinds of nanoparticle/plasmid complex-coated sutures significantly increased flexor tendon healing strength by 3.7 times for Ethilon and 5.8 times for PDS II, respectively, compared with the corresponding unmodified sutures. In the flexor tendon injury model, at 6 weeks after surgery, compared with the control suture, the nanoparticle/plasmid complexcoated sutures can significantly increase the gliding excursions of the tendon and inhibit the formation of adhesion. These results indicate that this nanoparticle/plasmid complex-coated suture is a promising tool for the treatment of injured tendons.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Gene-Loaded Nanoparticle-Coated Sutures Provide Effective Gene Delivery to Enhance Tendon Healing

et al. 2019

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“…104 Bommier et al reported on 23 patients with single-stage hemi–flexor digitorum profundus tendon transfer for delayed or failed flexor digitorum profundus repairs. 107 Functional outcomes were excellent for 14 patients, good for seven, and poor for two. The advantages of the hemi–flexor digitorum superficialis or flexor digitorum profundus transfers are the use of an intrasynovial donor tendon with similar excursion.…”

Section: Isolated Flexor Digitorum Profundus Injuriesmentioning

confidence: 92%

Secondary Procedures following Flexor Tendon Reconstruction

Gillis

Moran

2021

Plastic &Amp; Reconstructive Surgery

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he incidence of flexor tendon injury is 33 injuries per 100,000 person-years. 1,2 Advancements in flexor tendon repair, including wide-awake surgery, have led to improved outcomes. 3 In studies using multiple strand repairs and active range of motion, excellent results (defined as total active range of motion more than 150 degrees 4 ) have been noted in up to 86 percent of cases. 5,6 Despite this, reoperation still occurs. In a retrospective review of 5229 patients undergoing primary flexor tendon repair, there was a 6 percent reoperation rate, with 58 percent of these patients requiring tenolysis alone, 38 percent requiring rerepair alone, and 4 percent requiring both. 7 In such cases, the surgeon must have an understanding of the available reconstructive options for the treatment of patients with neglected, failed, or scarred tendon repairs. This article will review the indications and management options for failed flexor tendon surgery. THE MECHANICAL IMPACT OF FAILED FLEXOR TENDON REPAIRComplications following flexor tendon repairs include decreased range of motion, tendon bowstringing, quadriga, and lumbrical-plus deformity. 8-10 Compared to patients with primary flexor tendon repair, who have a mean QuickDASH score of 19.3, patients who require two-stage tendon reconstruction have a mean QuickDASH score of 34.4, emphasizing the importance of successful primary repair. 11 Flexor tendon pulley injury and tendon bowstringing can contribute to poor results. The pulley system consists of several fibro-osseous tunnels that run from the metacarpal head to the distal interphalangeal joint. These tunnels hold the tendons close to the joint's axis, allowing maximal motion for small amounts of tendon excursion. Biomechanical cadaver studies show an 8.5 percent increase in tendon excursion with loss of the A2 pulley, a 9.9 percent increase with loss of the A4 pulley, and a 33.7 percent increase with loss of both A2 and A4. 12 The loss of both pulleys leads to a 107 percent increase in the work of flexion. 12 This can lead to loss of motion and joint contracture. Pulley damage can be avoided by accessing and performing the tendon repair through the cruciate pulleys. Recent reports have shown that

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