Study on Evaluation and Management of Hand Injuries

Thangavelu, Manimaran; Veerasamy, Nagarajan; Kanthan, Anandan

doi:10.14260/jemds/2016/1072

Cited by 4 publications

(6 citation statements)

References 13 publications

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“…Consistent with previous studies ( 18 , 19 ), the findings of this study established that the majority of patients with tendon injuries were young (mean age 34.98 years), male (79.24%), and blue-collar workers (52.47%). In addition, 35.5% of the sample had fine jobs that relied on flexible hand functions, such as computer operators and handicraft makers.…”

Section: Discussionsupporting

confidence: 92%

Risk factors associated with tendon adhesions after hand tendon repair

et al. 2023

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BackgroundTendon adhesions after hand tendon repair are one of the most difficult complications of hand surgery and can cause severe disability. This study aimed to assess the risk factors associated with tendon adhesions after hand tendon repair to provide a theoretical foundation for the early prevention of tendon adhesions in patients with tendon injuries. Moreover, this study intends to increase doctors' awareness of the issue and serves as a reference for developing new prevention and treatment strategies.MethodsWe retrospectively analyzed 1,031 hand trauma cases that underwent repair after finger tendon injury in our department between June 2009 and June 2019. Tendon adhesions, tendon injury zones, and other relevant information were collected, summarized, and analyzed. The significance of data was determined using a t-test or Pearson's chi-square test, and odds ratios (OR) were calculated using logistic regression tests to describe factors associated with post-tendon repair adhesions.ResultsA total of 1,031 patients were enrolled in this study. There were 817 males and 214 females with an average age of 34.98 (2–82) years. The injured side included 530 left and 501 right hands. Postoperative finger tendon adhesions occurred in 118 cases (11.45%), including 98 males and 20 females, 57 left and 61 right hands. The risk factors for the total sample in the descending order were degloving injury, no functional exercise, zone II flexor tendon injury, time from injury to surgery >12 h, combined vascular injury, and multiple tendon injuries. The flexor tendon sample shared the same risk factors as the total sample. Risk factors for the extensor tendon sample were degloving injury, no functional exercise.ConclusionsClinicians should pay close attention to patients with tendon trauma in hand having the following risk factors: degloving injury, zone II flexor tendon injury, lack of functional exercise, time from injury to surgery >12 h, combined vascular injury, and multiple tendon injuries. Due to the high risk of post-repair adhesions in patients with the conditions mentioned above, individualized treatment measures should be designed for the risk factors, and postoperative functional exercise of the hand is required.

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Section: Discussionsupporting

confidence: 92%

Risk factors associated with tendon adhesions after hand tendon repair

et al. 2023

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“…We found that the dominant hand (50.5%) was affected somewhat more often than the non-dominant hand, which was similar to the findings reported by Thangavelu et al, [14] although other studies reported similar or less frequent rates. [13,17,18] The dominant hand is usually injured when using a sharp object directly or catching a falling object.…”

Section: Discussionsupporting

confidence: 91%

“…[6] Consistent with the previous studies, the findings obtained in this study demonstrated that most of the patients with flexor tendon injuries were young (mean age, 31.8), male (79.4%), and blue-collar workers (50.0%). [13,14] Proper injury management to optimize the long-term functional outcomes and economic burden are important among patients with these characteristics, who potentially have a prolonged working life expectancy requiring adequate hand function. [15] The rate of work-related injuries based on formal records in our study was 17.5%, which was markedly lower than that reported in previous studies.…”

Section: Discussionmentioning

confidence: 99%

Factors predicting reoperation after hand flexor tendon repair

Uçkun¹

2019

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: This single-center, retrospective study aims to analyze the sociodemographic, injury characteristics, and the total number of lost working days of patients undergoing hand flexor tendon repair and to identify factors predicting reoperation. METHODS: Hand flexor tendon repairs conducted using a four-strand modified Kessler core suture with early rehabilitation from January 2013 to December 2016 were included in this study. The variables evaluated in this study were patient sociodemographic and injury characteristics, number of lost working days, and reoperations because of rupture and/or adhesion formation. Injury severity was determined using Modified Hand Injury Severity Scoring (MHISS). Binary logistic regression analysis was conducted to identify the predictors of reoperation. RESULTS: A total of 194 patients were included in this study, who had experienced 329 tendon injuries. Participants were young (mean age, 31.8), mostly male (79.4%), and mostly blue-collar workers (50.0%). Most patients had a zone 2 injury affecting a single digit of the dominant hand. The mean MHISS value was 46.6, and the mean time to return to work was 114.0 days. A total of 37 (19.1%) patients required reoperation because of rupture and/or adhesion formation. Smoking, zone 2 injury, and high MHISS value were negative predictors of reoperation. CONCLUSION: To minimize the need for reoperation, surgeons and rehabilitation teams should take special care of patients with zone 2 injuries, high MHISS values, and smoking history.

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“…Прочность сухожильного шва зависит от следующих параметров: вид шовного материала; его калибр; количество нитей, проходящее через поперечник сухожилия; конфигурация петли; расстояние отступа от конца сухожилия; дополнительное натяжение места сухожильного контакта и расположение узла [10,11,12]. Исследования последних 20 лет были сфокусированы на вопросах изучения видов сухожильных швов и патоморфологии репарации сухожилий, но биомеханические свойства шовного материала при первичном восстановлении сухожилий сгибателей изучены недостаточно.…”

Section: гений ортопедии 2024;30(1)unclassified

Comparative experimental study of biomechanical features of suture materials in tendon repair

Malishevsky,

Paskov,

Sergeev

2024

jour

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Introduction Many different suture configurations and pathomorphology of tendon repair have been described for tendon repair over the past 20 years. However, the biomechanical properties of suture material at primary flexor tendon repair have not been sufficiently explored. A cyclic loading test is performed to evaluate the performance of the different sutures under repeated loading conditions simulating dynamic conditions in postoperative rehabilitation procedures.The objective was to compare the strength of suture materials under cyclic loading on a biological model of a tendon.Material and methods Eighty porcine digital flexor tendons were examined in a pilot study. The sutured tendons were tested with a universal testing machine. Tendon repair was produced using polypropylene in group I, braided polyamide suture in group II, complex polytetrafluoroethylene thread in group III and a thread of superelastic titanium nickelide in group IV. The standard Chang protocol was used for cyclic loading.Results The percentage of intact sutures was 25 % in group I and in group II, 80 % in group III and 85 % in group IV after completing the entire load cycle. A pairwise comparison showed suture disruption being more common for group I and group II as compared to group III and group IV. Irreversible gap was more common for group 1 as compared to group IV. Neither knot ruptures nor tissue cutting were seen in the groups.Discussion The topic of biomechanical properties of suture material remains poorly understood. Although static load testing is commonly used in current experimental studies and cyclic testing is suitable for simulating postoperative conditions. The search continues for the “ideal” suture material for flexor tendon repair to prevent tears and retain tensile properties until the repair reaches strength.Conclusion The threads of polytetrafluoroethylene and nickelide-titanium showed the best biomechanical properties for tendon repair in the form of linear strength, good elasticity and low plasticity of the suture material. There were no significant differences between polypropylene and braided polyamide threads.

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Study on Evaluation and Management of Hand Injuries

Cited by 4 publications

References 13 publications

Risk factors associated with tendon adhesions after hand tendon repair

Risk factors associated with tendon adhesions after hand tendon repair

Factors predicting reoperation after hand flexor tendon repair

Comparative experimental study of biomechanical features of suture materials in tendon repair

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