Prospective study of 80 volar wounds of the hand and wrist: Correlations between clinical examination and intraoperative findings

Baron-Trocellier, Thomas; Rongières, M.; Mericq, Olivier; Lupon, Elise; Mansat, Pierre

doi:10.1016/j.hansur.2020.03.006

Cited by 4 publications

(1 citation statement)

References 19 publications

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“…While complete laceration of the flexor tendon is relatively easy to diagnose clinically, management of a partial tendon laceration is not as straightforward [2]. On a physical exam, a partial tear might resemble a completely intact or completely lacerated tendon, posing a challenge for surgeons when determining when to surgically operate [3]. This introduces a debate as to what percentage of the tendon must be lacerated to necessitate surgical repair of the tendon.…”

Section: Introductionmentioning

confidence: 99%

Validating the use of three-dimensional ultrasound to detect partial flexor tendon lacerations

Mudathir,

Hutter,

Fares

et al. 2024

Medical Imaging 2024: Ultrasonic Imaging and Tomography

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Partial flexor tendon tears are common, but their diagnosis presents a few challenges. The degree of a partial flexor tendon tear necessitating surgical intervention remains under debate. This is primarily due to the lack of a sensitive and accessible imaging modality to assess the depth of a tendon laceration. We suggest the use of three-dimensional ultrasound (3DUS) to provide a more accurate grading of partial flexor tendon tears by providing surgeons with a decision-making tool to identify when surgical intervention is necessary. As a proof of concept, we dissected 6 digits from 2 fresh-frozen cadaveric specimens. Each digit was imaged using 3DUS and MRI to determine if the tendons and tendon lacerations are identifiable in the 3DUS images. This will be performed in preparation for a larger trial where each digit will be randomly assigned to an intact, low-grade laceration, or high-grade laceration group. 3DUS images were collected from each digit. MR images were also collected from each digit to compare the sensitivity of each imaging modality. Further analysis of the images will require a trained radiologist to grade the lacerations in each image, while being blinded to the actual grade of each laceration and comparing the radiologist's grading of each image to each laceration's actual grading to assess the sensitivity of 3DUS and MR in detecting partial tendon lacerations. We anticipate that 3DUS imaging to be comparable to MR imaging in detecting partial tendon tears. Future work includes applying load to the affected fingers to investigate whether that will improve partial tendon laceration detection. This work expands on the applications of 3DUS in musculoskeletal imaging and provides clinicians with an accessible tool to accurately detect and grade partial tendon lacerations.

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Section: Introductionmentioning

confidence: 99%