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Flexor tendon

Mutsuaki Edama, Tomoya Takabayashi, Takuma Inai, Takanori Kikumoto, Ryo Hirabayashi, Wataru Ito, Emi Nakamura, Masahiro Ikezu, Fumiya Kaneko, Ikuo Kageyama
PURPOSE: The purpose of this research was to clarify the relationships between quadratus plantae (QP) and flexor digitorum longus (FDL) and flexor hallucis longus (FHL) using large-scale specimens. METHODS: This study examined 116 legs from 62 Japanese cadavers. The QP was classified as: Type I, formed by the lateral and medial heads; Type II, the lateral head is absent; and Type III, the medial head is absent. The FHL branches to the lesser toes were classified as: Type A, connection from FHL to toe 2; Type B, connection from FHL to toes 2 and 3; Type C, connection from FHL to toes 2-4...
April 16, 2019: Surgical and Radiologic Anatomy: SRA
Shelley S Polly, Anne Ec Nichols, Elle Donnini, Daniel J Inman, Timothy J Scott, Stephanie M Apple, Stephen R Werre, Linda A Dahlgren
Adipose-derived stromal vascular fraction (SVF) is a heterogeneous population of cells that yields a homogeneous population of plastic-adherent adipose-derived multipotent stromal cells (ASC) when culture-expanded. SVF and ASC have been used clinically to improve tendon healing, yet their mechanism of action is not fully elucidated. The objective of this study was to investigate the potential for ASC to act as trophic mediators for tendon healing. Flexor digitorum superficialis tendons and adipose tissue were harvested from adult horses to obtain SVF, ASC and tenocytes...
April 12, 2019: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Yoichi Sugiyama, Kiyohito Naito, Kenji Goto, Yuko Kojima, Atsushi Furuhata, Mamoru Igarashi, Isao Nagaoka, Kazuo Kaneko
To evaluate the biological changes in tendons during the aging process, the present study examined the effect of aging on the tendon structure, distribution of collagen types I and III, and expression of tendon-associated genes, using flexor tendons in a mouse model. Histological assessment of the tendon structure and distribution of collagen types I and III were performed, and the expression of tendon-associated genes was evaluated in flexor digitorium longus tendons of young (8 weeks) and aged (78 weeks) female C57BL/6 mice...
April 2019: Biomedical Reports
A J Daniel, B S Leise, K T Selberg, M F Barrett
Injuries to the structures within the digital flexor tendon sheath (DFTS) can lead to lameness with a variable degree of effusion in horses. In some cases, effusion is absent or minimal, and this may be related to the chronicity and type of injury, or veterinary interventions. The purpose of this study was to determine if saline injection into the DFTS would improve ultrasonographic and magnetic resonance imaging of the distal limb without introducing artifact. Nine normal equine cadaver forelimbs were collected...
May 2019: Veterinary Journal
Eivind Strandenes, Peter Ellison, Anders Mølster, Nils R Gjerdet, Irene O Moldestad, Paul J Høl
The aim of the study was to present two new modifications of the Pulvertaft weave, allowing a higher number of weaves without the need for a longer overlap. The mechanical properties were measured and compared with the traditional technique. Forty-five pairs of porcine flexor tendons were randomized to a Pulvertaft repair with three weaves, a Double Pulvertaft and Locking Pulvertaft repairs. In the last two repairs one of the tendons in each repair was split in two before weaving. A difference in the maximum stiffness was observed between the three groups ( p = 0...
April 10, 2019: Journal of Hand Surgery, European Volume
Samantha L Piper, Lesley C Wheeler, Janith K Mills, Marybeth Ezaki, Scott N Oishi
BACKGROUND: Delayed diagnosis of flexor tendon injury in children is common, and consequent flexor sheath scarring may necessitate a 2-stage reconstruction. Previous studies show variable outcomes after 2-stage flexor reconstruction in children, especially those below 6 years old. We evaluated functional and subjective outcomes of primary repair and staged reconstruction of zone I and II tendon injuries in children under 6 years of age. METHODS: A retrospective chart review identified 12 digits in 10 patients who had undergone surgical treatment of a zone I or II flexor tendon injury...
May 2019: Journal of Pediatric Orthopedics
Yunfeng Zhou, Zhong Chen, Chuan Jiang, Bin Song
Contracture of the flexor hallucis longus (FHL) tendon is one of the most common factors leading to hallux flexion deformity. Few cases treated by arthroscopic technology have been reported. In this article, we perform a new method to lengthen the FHL tendon under an arthroscope. We present a case of 1 patient treated with this technique and followed for 2years. The appearance of his halluces remarkably improved at the follow-up visits, and movement was refined simultaneously. From the satisfactory effect of this operation, lengthening the FHL tendon under arthroscope is an effective method to correct flexion deformity of the hallux with minimal incisions...
April 6, 2019: Journal of Foot and Ankle Surgery
Ryan Riddick, Dominic J Farris, Luke A Kelly
The foot has been considered both as an elastic mechanism that increases the efficiency of locomotion by recycling energy, as well as an energy sink that helps stabilize movement by dissipating energy through contact with the ground. We measured the activity of two intrinsic foot muscles, flexor digitorum brevis (FDB) and abductor hallucis (AH), as well as the mechanical work performed by the foot as a whole and at a modelled plantar muscle-tendon unit (MTU) to test whether these passive mechanics are actively controlled during stepping...
January 31, 2019: Journal of the Royal Society, Interface
Katherine T Best, Alayna E Loiselle
During tendon healing, it is postulated that tendon cells drive tissue regeneration, whereas extrinsic cells drive pathologic scar formation. Tendon cells are frequently described as a homogenous, fibroblast population that is positive for the marker Scleraxis (Scx). It is controversial whether tendon cells localize within the forming scar tissue during adult tendon healing. We have previously demonstrated that S100 calcium-binding protein A4 (S100a4) is a driver of tendon scar formation and marks a subset of tendon cells...
April 5, 2019: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
Mohammad M Al-Qattan
PURPOSE: In the first stage of flexor tendon reconstruction, a silicon rod is fixed distally to the remnant of the flexor tendon at the distal phalanx. The proximal end of the rod is left free (unsutured) in the distal forearm. Hence, the rod insertion is not expected to result in any active flexion of the finger. The author reports on a case series in which adhesions have occurred between the rod and the adjacent flexor tendons in the distal forearm. METHODS: A retrospective study of 110 patients who underwent 2-stage flexor tendon reconstruction by the author revealed 5 patients in which the fingers were actively moving good enough after the insertion of the silicone rod to the extent that patients refused to undergo the second grafting procedure...
April 2, 2019: Annals of Plastic Surgery
Arnold-Peter C Weiss, Robin N Kamal, Gabrielle M Paci, Barrett A Weiss, Kalpit N Shah
PURPOSE: Most studies have demonstrated little difference in the outcome of the various techniques proposed for the surgical treatment of thumb carpometacarpal (CMC) arthritis. However, the difficulty and time required to perform each technique vary widely. In addition, the introduction of recent implants has increased the cost of the overall procedure. We hypothesize that using a simple, yet stable, suture suspension technique without tendon interposition or ligament reconstruction yields similar results to conventional approaches with less operative time...
April 2019: Journal of Hand Surgery
Shohei Anno, Tadashi Okano, Kenji Mamoto, Yuko Sugioka, Setsuko Takeda, Ayumi Hashimoto, Emi Yamashita, Rika Morinaka, Hatsue Ueda, Kentaro Inui, Tatsuya Koike, Hiroaki Nakamura
OBJECTIVES: This study aimed to compare median nerve stiffness measured by ultrasound real-time tissue elastography in patients with and without rheumatoid arthritis (RA and non-RA groups, respectively). METHODS: Altogether, 402 hands of 201 RA group and 222 hands of 111 non-RA group were included in the study. Ultrasonography was performed to evaluate the circumference, cross-sectional area (CSA) and strain ratio as an elasticity of the median nerve at the inlet level of the carpal tunnel and the proximal portion of the carpal tunnel inlet...
April 5, 2019: Modern Rheumatology
Jonas S Nordin, Ola Olsson, Karl Lunsjö
BACKGROUND: The gracilis tendon is commonly used as an autograft to reconstruct torn tendons or ligaments in many parts of the body. Little is known about the subjective and functional outcome after gracilis tendon harvest. The aim of this study was to evaluate the outcome of the donor leg in patients undergoing such surgery. METHODS: Patients with chronic acromioclavicular joint dislocations undergoing coracoclavicular ligament reconstructions using autogenous gracilis tendon grafts were eligible for this study...
March 30, 2019: BMC Musculoskeletal Disorders
Koji Fujita, Kenji Kimori, Akimoto Nimura, Atsushi Okawa, Yoshikazu Ikuta
BACKGROUND: Carpal tunnel syndrome (CTS) is common among patients receiving hemodialysis and deeply influences their daily life. Amyloid deposits are considered the main reason for median nerve compression, but its prevalence is unclear. Therefore, to determine the main region of amyloid deposition inside the carpal tunnel, we measured the cross-sectional area (CSA) of each component of the carpal tunnel in preoperative magnetic resonance imaging (MRI). METHODS: Thirty-five hemodialysis patients (HD group) and age- and sex-matched 35 non-hemodialysis patients (non-HD group), who underwent the first surgery for CTS in registered hospitals from 2005 to 2015, were retrospectively enrolled...
March 28, 2019: Journal of Orthopaedic Surgery and Research
Zihui Chi, Lin Huang, Shaoli Ge, Huabei Jiang
PURPOSE: Thermoacoustic tomography (TAT) has been studied to image joints. While several joint tissues could be thermoacoustically imaged, tendons and bone could not be recovered completely or clearly. The purpose of this study was to overcome this limitation. METHODS: We developed a novel TAT system based on anti-phase microwave illumination method to image the proximal interphalangeal joint and middle phalanx of a right middle finger from a healthy volunteer. The performance of this new system for imaging joints and tendons was compared with that by in-phase microwave illumination and a conventional pyramidal horn antenna...
March 28, 2019: Medical Physics
Özlem Çolak, Yüksel Kankaya, Nezih Sungur, Kadri Özer, Koray Gürsoy, Kemal Şerbetçi, Uğur Koçer
Background: The management of flexor tendon injuries has evolved in recent years through industrial improvements in suture materials, refinements of repair methods, and early rehabilitation protocols. However, there is no consensus on the ideal suture material and technique. This study was conducted to compare the tensile strength, repair time, and characteristics of 4-strand cruciate, modified Kessler, and 4-strand horizontal intrafiber barbed sutures for flexor tenorrhaphy with a 12-mm suture purchase length in an animal model...
March 27, 2019: Archives of Plastic Surgery
Kulveer Mankia, Maria-Antonietta D'Agostino, Emma Rowbotham, Elizabeth Ma Hensor, Laura Hunt, Ingrid Möller, Misabel Miguel, José Ramon Mérida-Velasco, Jorge Murillo-González, Esperanza Naredo, Jacqueline Leong Nam, Ai Lyn Tan, Jane E Freeston, Andrew Grainger, Paul Emery
Interosseous tendon inflammation (ITI) has been described in rheumatoid arthritis (RA). Whether ITI occurs in at-risk individuals before the onset of clinical synovitis is unknown. OBJECTIVES: To investigate, by MRI, ITI in anti-cyclic citrullinated peptide (CCP)-positive at-risk individuals (CCP +at risk) and to describe the anatomy, prevalence and clinical associations across the RA continuum. METHODS: Hand MRI was performed in 93 CCP + at risk, 47 early RA (ERA), 28 established 'late' RA (LRA) and 20 healthy controls (HC) and scored for ITI, flexor tenosynovitis (TSV) and RA MRI scoring at the metacarpophalangeal joints (MCPJs)...
March 23, 2019: Annals of the Rheumatic Diseases
Thiago André Carniel, Ana Bárbara Krummenauer Formenton, Bruno Klahr, Jakson Manfredini Vassoler, Carlos Rodrigo de Mello Roesler, Eduardo Alberto Fancello
The transverse deformations of tendons assessed in tensile tests seems to constitute a controversial issue in literature. On the one hand, large positive variations of the Poisson's ratio have been reported, indicating volume reduction under tensile states. On the other hand, negative values were also observed, pointing out an auxetic material response. Based on these experimental observations, the following question is raised: Are these large and discrepant transverse deformations intrinsically related to the constitutive response of tendons or they result from artifacts of the mechanical test setup? In order to provide further insights to this question, an experimental and numerical study on the transverse kinematics of tendons was carried out...
March 8, 2019: Journal of Biomechanics
Joshua A Gillis, Sanjeev Kakar
PURPOSE: To describe the placement of volar midcarpal portals using the inside-out technique, and the surrounding anatomical structures at risk. METHODS: Five fresh-frozen cadavers were used. Volar ulnar midcarpal (VUMC) and volar radial midcarpal (VRMC) portals were placed using an inside-out technique. The distance between these portals to surrounding anatomical structures was measured in millimeters using a caliper. RESULTS: The VUMC portal pierced the flexor digitorum profundus tendon to the middle finger in 1 specimen...
March 19, 2019: Journal of Hand Surgery
Chia H Wu, Seth Shoap, Robert J Strauch
BACKGROUND: Flexor pollicis longus (FPL) tendon lacerations typically occur via sharp mechanisms such as knife injury. When the injury is chronic, it may be difficult to perform a tension free repair, and tendon lengthening may be required. This article proposes a technique that transposes the proximal tendon stump over the thenar eminence subcutaneously, out of the carpal tunnel, in an attempt to gain additional tendon length by eliminating the sharp turn the FPL takes. METHODS: A total of 17 cadaveric hands were used...
March 20, 2019: Hand: Official Journal of the American Association for Hand Surgery
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