The Vascularity of the Flexor Pollicis Longus Tendon

Hergenröeder, Patrick T.; Gelberman, Richard H.; Akeson, Wayne H.

doi:10.1097/00003086-198201000-00046

Cited by 30 publications

(10 citation statements)

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“…A lack of extrinsic vascular supply of the FPL tendon immediately palmar to the metacarpophalangeal joint was identified by Lundborg (1979). Hergenroeder et al (1982) found that there is a zone of relative avascularity of the tendon at the same point. This is also illustrated by Tubiana (1988).…”

Section: Article In Pressmentioning

confidence: 99%

Early Active Mobilization of Primary Repairs of the Flexor Pollicis Longus Tendon with Two Kessler Two-Strand Core Sutures and a Strengthened Circumferential Suture

Sirotakova

Elliot

2004

Journal of Hand Surgery

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This study reports our treatment of divided flexor pollicis longus (FPL) tendons by primary repair from 1999 to 2002. Forty-eight FPL repairs were performed using two Kessler two-strand repairs with a cross-linked Silfverskiold circumferential suture. All were rehabilitated by early active mobilization. Excellent or good results were observed in 73/77% of cases (White/Buck-Gramcko assessments, respectively). No patients (0%) ruptured their repair as a result of early active mobilization. Two patients (4%) developed post-operative infections with wound and tendon dehiscence. This combination of repairs addresses the problem of rupture of FPL during early mobilization which we experienced in previous studies. Its problems and alternatives are discussed.

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Section: Article In Pressmentioning

confidence: 99%

Early Active Mobilization of Primary Repairs of the Flexor Pollicis Longus Tendon with Two Kessler Two-Strand Core Sutures and a Strengthened Circumferential Suture

Sirotakova

Elliot

2004

Journal of Hand Surgery

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“…As the tendon repairs were not limited to one zone of injury, it is difficult to compare any results with accuracy. In zone II of the thumb, there is a pulley system and a local avascular region of the tendon [13] and is typically known as “no man’s land.” These are typically associated with a poorer clinical outcome, including TAM [14].…”

Section: Reviewmentioning

confidence: 99%

Negative Predictors of Outcomes of Flexor Tendon Repairs

Hurley¹,

Reilly²,

Callaghan³

et al. 2019

Cureus

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The current trend in hand surgery has streamlined the treatment of acute hand trauma to the modern-day surgery unit. As the volume of hand trauma caseloads continues to increase, it is becoming increasingly difficult to schedule patients for theater on the day of injury. It, therefore, becomes paramount to adequately triage patients in accordance with best clinical evidence and predictors of poor clinical outcomes. Animal models suggest that the earlier flexor tendons are repaired, the better the patient functional outcome. The largest study to date examining the timing of injury to functional post-operative outcome also recognizes that the faster these injuries are repaired, the better the patient outcome. Age-related changes to tendon biomechanics and structure are well-documented. However, no conclusive evidence exists specific to the degenerative changes and mechanical properties of flexor tendons in humans. The animal model strongly suggests that increasing age is associated with local architectural and biological changes that directly affect the tendon repair functional outcome. Although retrospective analyses to date suggest that smoking is a negative outcome predictor for functional tendon outcome, no prospective large-scale studies exist. A large, single-center prospective study specifically examining the positive and negative outcome predictors of flexor tendon repairs and functional post-operative outcome is warranted. The negative predictive model of patient care may enable us to further council patients preoperatively and stratify patients according to clinical need.

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“…Subjective function of the thumb pre-and postoperatively was assessed by the patients on scale of 0 to 10, where 10 is normal and 0 indicates no thumb function possible. These numbers were summarised as excellent (9,10), good (6,7,8), fair (3,4,5) and poor (0,1,2). 2 The final result of overall hand function was assessed by the patient on a scale of 0 (no function) to 10 (normal function).…”

Section: Resultsmentioning

confidence: 99%

“…Rupture in zone 2 is higher than zone 1 because of lack of extrinsic vascular supply immediately palmer to MCP joint, identified by Lundburg, Hergenroeder and Tubiana [3][4][5] .…”

Section: Introductionmentioning

confidence: 99%

Management of Flexor Pollicis Longus Injury - Experience in BSMMU

Islam

Begum²,

Datta³

et al. 2021

J Shaheed Suhrawardy Med Coll

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Anatomic consideration: Flexor pollicis longus (FPL) tendon arises from volar aspect of middle third of radial shaft and from the lateral aspect of interosseous membrane. The anterior interosseous branch of median nerve innervates the muscle in the proximal/mid forearm. Blood supply is predominantly from radial artery. Abstract Purpose: The purpose of this study was to evaluate the results of repair and one stage reconstruction of FPL injury and to find out complications and rupture rate and effectiveness of repair and reconstruction. Method: This retrospective review was carried out in Bangabandhu Sheikh Mujib Medical University from January 2015 to December 2018. 30 consecutive patients were enrolled in the study. 4 strands core suture with simple circumferential suture were used for repair and reconstruction. Tendon transfer was done in few cases. Power grip, active and passive range of motion, American Society for Surgery of the Hand criteria and Buck-Gramcko criteria were used for outcome assessment. Results: Out of 30 patients, 20 (67%) were male and 10 (33%) were female. Mean age was 30 years. Mean follow up period was 1.5 years. All cases were due to various type of cut injuries. In subjective assessment 40% patients achieved excellent, 50% good, 10% fair results. Our rupture rate was 0%. Mean power grip, pinch grip strength of index and key pinch strength were 87.5%, 68.18% and 86.66% respectively from contralateral normal hand. Active range of motion of IP joint was 64.28% of normal side. Conclusions: Use of 4 strands core sutures and early active motion give good to excellent results in 90% cases of repair, reconstruction and tendon transfer in FPL injuries with 0% rupture rate J Shaheed Suhrawardy Med Coll, December 2020, Vol.12(1); 20-26

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The Vascularity of the Flexor Pollicis Longus Tendon

Cited by 30 publications

References 0 publications

Early Active Mobilization of Primary Repairs of the Flexor Pollicis Longus Tendon with Two Kessler Two-Strand Core Sutures and a Strengthened Circumferential Suture

Early Active Mobilization of Primary Repairs of the Flexor Pollicis Longus Tendon with Two Kessler Two-Strand Core Sutures and a Strengthened Circumferential Suture

Negative Predictors of Outcomes of Flexor Tendon Repairs

Management of Flexor Pollicis Longus Injury - Experience in BSMMU

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