Complications experienced in the rehabilitation of zone I flexor tendon injuries with dynamic traction splinting

Gerbino, Peter G.; Saldana, Miguel J.; Westerbeck, Peggy; Schacherer, Timothy G.

doi:10.1016/0363-5023(91)90194-g

Cited by 36 publications

(37 citation statements)

References 18 publications

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“…The usual complications with the POS are infection and irritation of skin, nerve, germinative matrix and nail. The complication rate varies from 35 to 65% in previous publications (Gerbino et al, 1991, Kang et al, 2008; hence the 12/35 (38 %) observed in our material is comparable with the literature. We did not observe any complication with TILT, implying it is a safer alternative than POS.…”

Section: Fdp Reattachmentsupporting

confidence: 90%

Comparison of modified Kessler and Yotsumoto-Dona suture: A biomechanical study on porcine tendons

Rigó

Haugstvedt

Ludvigsen

et al. 2012

Journal of Plastic Surgery and Hand Surgery

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There is a need for a strong suture technique that allows early active mobilisation after repair of flexor tendons, but the best method has not yet been found. The aim of this study was to compare the modified Kessler suture biomechanically with a newer, two-strand suture. Eighteen porcine tendons were cut and repaired according to either the grasping modified Kessler suture or the combined side-locking loop technique (Yotsumoto) and interlocking horizontal mattress suture (Dona). The specimens were tested linearly to failure. The 2 mm gap force, yield force, ultimate force, stiffness, energy to yield, and energy to failure were all significantly higher (p value = 0.005, 0.003, <0.001, 0.001, 0.004, and 0.001, respectively) in the Yotsumoto-Dona group (median values (IQR): 30.9 (28.1-39.5) N, 82.7 (64.9-114.1) N, 82.7 (76.6-114.1) N, 12.5 (10-14.5) N/mm, 0.45 (0.2-0.5) J, and 0.45 (0.35-0.5) J) than in the modified Kessler group (25.8 (12.2-28.1) N, 35 (24.6-54.4) N, 50.9 (34.4-55.1) N, 7 (5.8-91) N/mm, 0.09 (0.06-0.18) J, and 0.21 (0.18-0.28) J). All Yotsumoto-Dona specimens had a yield force exceeding 35 N, while in the Kessler group only four did. The early yielding rate was 6/9 and 2/9 in the modified Kessler and the Yotsumoto-Dona groups, respectively (p = 0.15). Most of the core sutures failed by breakage, but three Yotsumoto knots loosened. All the simple running and six of the Dona epitendinous sutures failed predominantly by pulling-out, and by breakage at the intersections in three of the latter. The relatively easy two-strand Yotsumoto-Dona suture is likely to withstand the loads of active finger flexion, whereas the modified Kessler suture is probably not.

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Section: Fdp Reattachmentsupporting

confidence: 90%

Comparison of modified Kessler and Yotsumoto-Dona suture: A biomechanical study on porcine tendons

Rigó

Haugstvedt

Ludvigsen

et al. 2012

Journal of Plastic Surgery and Hand Surgery

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“…Zone 1a FDP tendon injuries are difficult to treat and the complication rate for surgery in this zone is very high, varying from 35% (Gerbino et al, 1991) to 60% (Evans, 1990) in previous studies. Our attention was drawn to our own complication rate for surgery in zone 1a by several cases (Cases 1, 2 and 3), but our overall complication rate was very high.…”

Section: Discussionmentioning

confidence: 93%

The Morbidity of the Button-over-Nail Technique for Zone 1 Flexor Tendon Repairs. Should we still be using this Technique?

Kang

Marsh

Dewar

2008

J Hand Surg Eur Vol

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The button-over-nail technique is commonly used to fix the core suture to the distal phalanx for flexor digitorum profundus repairs in zone 1. We report a retrospective study of 23 consecutive patients who had a repair of the flexor digitorum profundus tendon in zone 1 using the button-over-nail technique. Fifteen patients experienced a complication, of which ten were directly related to the button-over-nail technique. Complications included nail deformities, fixed flexion deformities of the distal interphalangeal joint, infections and prolonged hypersensitivity. Two patients required amputation of the fingertip. We recommend that the button-over-nail technique should be avoided or used only with caution and with close attention to the details of the technique.

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“…Direct repair immediately after flexor injury is standard clinical practice [4][5][6] , but flexor tendon reconstruction may be needed to restore tendon function if the primary repair has failed 7,8 . Flexor tendon Disclosure: One or more of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of an aspect of this work.…”

mentioning

confidence: 99%

Surface Modification with Chemically Modified Synovial Fluid for Flexor Tendon Reconstruction in a Canine Model in Vivo

Reisdorf

Thoreson

et al. 2015

The Journal of Bone and Joint Surgery

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Complications experienced in the rehabilitation of zone I flexor tendon injuries with dynamic traction splinting

Cited by 36 publications

References 18 publications

Comparison of modified Kessler and Yotsumoto-Dona suture: A biomechanical study on porcine tendons

Comparison of modified Kessler and Yotsumoto-Dona suture: A biomechanical study on porcine tendons

The Morbidity of the Button-over-Nail Technique for Zone 1 Flexor Tendon Repairs. Should we still be using this Technique?

Surface Modification with Chemically Modified Synovial Fluid for Flexor Tendon Reconstruction in a Canine Model in Vivo

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