Regaining satisfactory digital function after flexor tendon laceration and repair within the digit has long been one of the most difficult problems in hand surgery. Until the 1960s it was universally recommended that tendons divided in the digit (then referred to as “no man’s land”) should not be repaired. Bunnell taught that “it is better to remove the tendons entirely from the finger and graf...

The purpose of this study was to investigate the preventive effect of mannose-6-phosphate on flexor tendon adhesion formation. From a total of 84 adult New Zealand White rabbits, 36 were randomly divided into 2 groups, the normal saline group and the mannose-6-phosphate group, after anastomosis of the flexor tendons. Tendons were harvested at 4 weeks, and biomechanics testing was conducted. The...

PURPOSE To determine whether there were differences between plate position in patients who had postoperative flexor tendon ruptures following volar plate fixation of distal radius fractures and those who did not. METHODS Three blinded reviewers measured the volar plate prominence and position on the lateral radiographs of 8 patients treated for flexor tendon ruptures and 17 matched control pa...

Flexor tendon injuries are among the most challenging problems for hand surgeons and tissue engineers alike. Not only do flexor tendon injuries heal with poor mechanical strength, they can also form debilitating adhesions that may permanently impair hand function. While TGF-β1 is a necessary factor for regaining tendon strength, it is associated with scar and adhesion formation in the flexor te...

Tendon surgery is unique because it should ensure tendon gliding after surgery. Tendon surgery now can be performed under local anesthesia without tourniquet, by injecting epinephrine mixed with lidocaine, to achieve vasoconstriction in the area of surgery. This method allows the tendon to move actively during surgery to test tendon function intraoperatively and to ensure the tendon is properly...

BACKGROUND Adhesion formation limits functional recovery after flexor tendon repair. Various growth factors have been implicated in the adhesion scar process. Early growth response factor-1 (EGR-1), a transcription factor associated with synthesis of a variety of key fibrotic growth factors and expression of extracellular matrix genes, has never been identified in a tendon repair model. METHO...

BACKGROUND Acute traumatic tendon injuries of the hand and wrist are commonly encountered in the emergency department. Despite the frequency, few studies have examined the true incidence of acute traumatic tendon injuries in the hand and wrist or compared the incidences of both extensor and flexor tendon injuries. METHODS We performed a retrospective population-based cohort study of all acute...

A 20-year-old man suffered a closed rupture of both flexor tendons in the middle finger while playing rugby. Primary repair of the flexor digitorum profundus and excision of the flexor digitorum superficialis was performed. At follow up he reported a Disabilities of the Arm, Shoulder and Hand score of 0 and unrestricted return to activities.

The excursion resistance between the tendon and pulley is an important factor contributing to the limitation of function after surgery to the hand. The administration of hyaluronic acid (HA) in the early rehabilitation after tendon grafting may help to prevent adhesions. We evaluated changes in the excursion resistance between potential sources of flexor tendon grafts and the annular pulley in ...

tendon never restores the complete biological and mechanical properties after healing. bone marrow and recently adipose tissue have been used as the sources of mesenchymal stem cells, which have been proven to enhance tendon healing. stromal vascular fraction (svf), derived from adipose tissue by an enzymatic digestion, represents an alternative source of multipotent cells, which undergo differ...