Modified Brunelli Pull-Out Technique in Flexor Tendon Repair for Zone II: A Study on 58 Cases

Georgescu, Alexandru Valentin; Matei, Ileana Rodica; Capota, Irina; Filip, Adriana; Olariu, Octavian

doi:10.1007/s11552-011-9345-5

Cited by 10 publications

(3 citation statements)

References 38 publications

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“…A simplified experimental repair condition was created using a modified Kessler suture penetrating 5 mm into the tendon end, measured with a ruler and forming a loop approximately 40-mm in perimeter (Figure 1). This suture technique was selected because this, along with a circumferential continuous running suture, is one of the most common techniques applied for zone II tendon repair 20 .…”

Section: Methodsmentioning

confidence: 99%

The Effect of 1-Ethyl-3-(3-Dimethylaminopropyl) Carbodiimide Suture Coating on Tendon Repair Strength and Cell Viability in a Canine Model

Thoreson

Hiwatari

et al. 2015

The Journal of Hand Surgery

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Purpose To determine if impregnating a suture with a cross-linking agent, f 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide hydrochloride (EDC), improved suture pull-out strength and cell viability. Methods Canine flexor digitorum profundus tendons were cut in canine zone D, and a single suture loop was placed in each end, with sutures soaked in either saline or in an EDC solution with a concentration of 1%, 10%, or 50%. Suture pull-out strength, stiffness, and elongation to failure was determined by pulling the loop until failure. Cytotoxicity of the EDC treatment was evaluated by suspending treated sutures over cultured tenocytes. Results Mechanical properties for the EDC-treated side were improved over controls when treated with the 10% and 50% EDC solutions. The ratio of dead to live cells was significantly increased at all distances from the suture for the 50%-EDC-treated group. Conclusions Suture treated with a 10% EDC solution provided the best combination of mechanical reinforcement and limited toxicity. Clinical Relevance Sutures so treated may improve the ability of a tendon repair to sustain early mobilization.

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Section: Methodsmentioning

confidence: 99%

The Effect of 1-Ethyl-3-(3-Dimethylaminopropyl) Carbodiimide Suture Coating on Tendon Repair Strength and Cell Viability in a Canine Model

Thoreson

Hiwatari

et al. 2015

The Journal of Hand Surgery

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“…59,60 In addition to the four-strand core suture technique, several different techniques involving grasping, crossstitch, mattress, cruciate, and locking configurations have been used in flexor tendon repair, although not reported in our tracer data. 30,61…”

Section: Surgical Treatmentmentioning

confidence: 99%

Practice Patterns in Operative Flexor Tendon Laceration Repair: A 15-Year Analysis of Continuous Certification Data from the American Board of Plastic Surgery

Weissman

Sasson

Chappell

et al. 2022

Plastic and Reconstructive Surgery - Global Open

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Background:The American Board of Plastic Surgery has been collecting practice data on operative repair of flexor tendon lacerations since 2006, as part of its Continuous Certification program. Methods: Data on operative repair of flexor tendon lacerations from 2006 to 2014 were reviewed and compared with those from 2015 to 2020. National practice trends observed in these data were evaluated and reviewed alongside published literature and evidence-based medicine. Results: In total, 780 patients with flexor tendon laceration injuries were included. Mean patient age was 38 years; mean time between tendon injury and first evaluation was 4 days, and the mean time from injury to operative repair was 12 days. Four-strand sutures remain the most common technique of tendon repair (57%). In the recent cohort, there were significant decreases in tourniquet use (94% versus 89%), general anesthesia (88% versus 74%), and monofilament sutures (44% versus 35%), with a significant increase reported in preserving the A1 pulley (20% versus 29%). Postoperative movement was described as "almost full range of motion" or "good" in 70% of cases, and 74% of patients were satisfied with their results. Postoperative adverse events were reported in 26% of cases, with the most common complications being tendon adhesions (14%) and rupture (3%). Conclusions: Review of The American Board of Plastic Surgery tracer data for operative repair of flexor tendon lacerations establishes a framework by which surgeons can evaluate how their current practice aligns with that of their peers, and whether their practice patterns remain current relative to recommendations from evidence-based medicine.

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“…Moreover, as each muscular contracture results in tighter contact between tendon stumps the risk of gap formation is minimised. This repair has only been used in 58 patients but achieved excellent results in all cases (Strickland criteria), yet 31% of patients had extension deficits of 10–20° and a complete range of flexion was restored in 57.5% of fingers [31,32].…”

Section: Zone 2 Repairmentioning

confidence: 99%

The evidence-base for the management of flexor tendon injuries of the hand: Review

Ishak

Rajangam

Khajuria

2019

Annals of Medicine and Surgery

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Modified Brunelli Pull-Out Technique in Flexor Tendon Repair for Zone II: A Study on 58 Cases

Abstract: Our study demonstrates that, by moving the tension from the level of disruption to the finger pulp, the rehabilitation program can begin very early post surgery. We had 0% ruptures.

Cited by 10 publications

References 38 publications

The Effect of 1-Ethyl-3-(3-Dimethylaminopropyl) Carbodiimide Suture Coating on Tendon Repair Strength and Cell Viability in a Canine Model

The Effect of 1-Ethyl-3-(3-Dimethylaminopropyl) Carbodiimide Suture Coating on Tendon Repair Strength and Cell Viability in a Canine Model

Practice Patterns in Operative Flexor Tendon Laceration Repair: A 15-Year Analysis of Continuous Certification Data from the American Board of Plastic Surgery

The evidence-base for the management of flexor tendon injuries of the hand: Review

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