Primary Repair Of Flexor Tendons In The Hand Without Immobilisation – Preliminary Report

HAND ◽  
1978 ◽  
Vol os-10 (1) ◽  
pp. 37-47 ◽  
Author(s):  
Hilton Becker
Keyword(s):  
Blood Supply ◽  
Preliminary Report ◽  
Suture Material ◽  
Flexor Tendon ◽  
Primary Repair ◽  
Tendon Repair ◽  
Gap Formation ◽  
Flexor Tendon Repair ◽  
New Approach ◽  
Flexor Tendons

summary A new approach to the problem of flexor tendon repair within the fibro-osseous canal is presented. Using a technique of bevelling the tendon ends and suturing with a fine suture material, under magnification, a sufficiently strong junction is obtained, which enables immediate active mobilisation without strangulation of the blood supply. The junction can resist gap formation up to tensions of 4 Kg. It is postulated that under these conditions tendon nutrition is minimally interfered with, adhesions do not form, and the tendon heals by its own intrinsic healing ability.

Influence of Core Suture Material and Peripheral Repair Technique on the Strength of Kessler Flexor Tendon Repair

2003 ◽  
Vol 28 (4) ◽  
pp. 357-362 ◽  
Author(s):  
V. MISHRA ◽  
J. H. KUIPER ◽  
C. P. KELLY
Keyword(s):  
Cyclic Loading ◽  
Suture Material ◽  
Flexor Tendon ◽  
Tendon Repair ◽  
Flexor Tendon Repair ◽  
Flexor Tendons ◽  
Repair Technique ◽  
Nylon Suture ◽  
Load To Failure ◽  
The Cross

The purpose of our study was to determine the most favourable combination of core suture material and peripheral repair technique for Kessler tendon repair. Thirty freshly thawed pig flexor tendons were repaired by a Kessler technique, either with braided polyester or monofilament nylon suture. A peripheral augmentation was done using one of the three techniques – running, cross-stitch and Halsted. All repairs were tested by cyclic loading, followed by load-to-failure. During cyclic loading six of the 15 tendons with a nylon core failed, but none with a braided polyester core. Irrespective of peripheral technique, the monofilament nylon core suture allowed early central cyclic gapping, resulting in failure of the repair. During load-to-failure testing, the running stitch proved weakest and the cross-stitch repair toughest.

FLEXOR TENDON REPAIR, HEALING AND REHABILITATION: A BRIEF COMMENTARY

Hand Surgery ◽  
2002 ◽  
Vol 07 (01) ◽  
pp. 29-31 ◽  
Author(s):  
John A. McAuliffe
Keyword(s):  
Flexor Tendon ◽  
Primary Repair ◽  
Muscle Tension ◽  
Tendon Repair ◽  
Tendon Healing ◽  
Tissue Reaction ◽  
Rate Of Change ◽  
Clinical Approach ◽  
Flexor Tendon Repair ◽  
Flexor Tendons

Twenty years ago, we concluded that it was useless to use suture material strong enough to allow early mobilisation, since material of this sort creates problems in the form of connective tissue reaction and even tendon necrosis. It is better to use what is called "the blocked suture", which abolishes muscle tension on the repair, and, therefore, makes it possible to bring the tendon ends accurately together by fine sutures too weak to resist any muscle fore.19 This statement, from Claude Verdan's Founders Lecture to the American Society for Society of the Hand only 30 years ago, highlights the dramatic rate of change in our understanding and clinical approach to flexor tendon repair. At the time these words were spoken, Verdan and some of his more adventurous contemporaries were challenging the currently accepted dictum that repair of flexor tendons divided in the digit should not be attempted. This early work on the primary repair of flexor tendons by Verdan,20 Kleinert and associates,12 and Kessler and Nissim,11 among others, forever changed the landscape of Bunnell's "no man's land",and paved the way for the clinical advances and explosion of research into flexor tendon healing and repair that have occured in the last several decades.

scholarly journals Ischaemic contracture of the hand

2006 ◽  
Vol 39 (01) ◽  
pp. 94-102
Author(s):  
G. Balakrishnan
Keyword(s):  
Suture Material ◽  
Flexor Tendon ◽  
Tendon Repair ◽  
Hypodermic Needle ◽  
Flexor Tendon Repair ◽  
Active Motion ◽  
Custom Made

ABSTRACTStronger flexor tendon repairs facilitate early active motion therapy protocols. Core sutures using looped suture material provide 1 ½ to twice the strength of Kessler′s technique (with four strand and six strand Tsuge technique respectively). The technique is well-described and uses preformed looped sutures (supramid). This is not available in many countries and we describe a technique whereby looped sutures can be introduced in flexor tendon repair by the use of 23 G hypodermic needle and conventional 4.0 or 5.0 sutures. This is an alternative when the custom made preformed sutures are not available. This can be practiced in zone 3 to zone 5 repairs. Technical difficulties limit its use in zone 2 repairs.

Factors Affecting the Strength of Flexor Tendon Repair

1992 ◽  
Vol 17 (5) ◽  
pp. 550-552 ◽  
Author(s):  
D. BHATIA ◽  
K. E. TANNER ◽  
W. BONFIELD ◽  
N. D. CITRON
Keyword(s):  
Cyclic Load ◽  
Suture Material ◽  
Flexor Tendon ◽  
Tendon Repair ◽  
Flexor Tendon Repair ◽  
Factors Affecting ◽  
Full Strength ◽  
Load Tests

The effects of different thicknesses and configurations of core sutures were studied in human cadaveric flexor tendon repairs. Both straight and cyclic load tests were employed. To exploit the full strength of 4/0 suture material, the Kessler repair using four locked single knots would seem to be appropriate.

Gap Formation During Cyclic Testing of Flexor Tendon Repair

2018 ◽  
Vol 43 (6) ◽  
pp. 570.e1-570.e8 ◽  
Author(s):  
Lasse Linnanmäki ◽  
Harry Göransson ◽  
Jouni Havulinna ◽  
Petteri Sippola ◽  
Teemu Karjalainen ◽  
...  
Keyword(s):  
Flexor Tendon ◽  
Tendon Repair ◽  
Cyclic Testing ◽  
Gap Formation ◽  
Flexor Tendon Repair

Flexor tendon repair with a polytetrafluoroethylene (PTFE) suture material

2019 ◽  
Vol 139 (3) ◽  
pp. 429-434
Author(s):  
Elias Polykandriotis ◽  
Foued Besrour ◽  
Andreas Arkudas ◽  
Florian Ruppe ◽  
Katharina Zetzmann ◽  
...  
Keyword(s):  
Suture Material ◽  
Flexor Tendon ◽  
Tendon Repair ◽  
Flexor Tendon Repair

THE LONG GRAFT IN FLEXOR TENDON REPAIR — A 30-YEAR EXPERIENCE

Hand Surgery ◽  
1996 ◽  
Vol 01 (02) ◽  
pp. 141-146
Author(s):  
Ivan Matev
Keyword(s):  
Flexor Tendon ◽  
Tendon Repair ◽  
Flexor Tendon Repair ◽  
Flexor Tendons ◽  
Grafting Procedure

The author’s 30 years experience with long grafting procedure is presented and the essentials of the technique are outlined. When both flexor tendons are cut in Zone 2, secondary repair using long graft gives the possibility of better results than the conventional tendon grafting, when scarring exists in the palm.

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