Anatomical Reconstruction of Finger Flexors in Scary FibroOsseous Canals

Abstract


Introduction. Healing of finger flexor tendons after reconstructive operations takes place under the conditions of scary changes in fibro-osseous canals. Determining factor for the functional outcome is the intensity of commissural process around the flexor tendon. The problem of conventional treatment is the impossibility to ensure the ingrowth of fibrous tissue into the scar zone with simultaneous formation of smooth canal wall. Patients and methods. Eighty six patients with 94 finger flexor tendon injuries along the fibroosseous canals were operated on. Eighteen operations with primary delayed deep flexor tendon suture, 8 operations with repeated suture and 7 operations of tendon tenolysis after primary suture were supplemented with the proposed method of temporary isolation of the reconstructed tendon within a dissected polymeric tube. The tube isolates the tendon from blood clots, forms the smooth canal wall. Results. Finger function was assessed in 6 and 12 months. After operations supplemented by temporary isolation of the tendon within the polymeric tubes excellent and good results were achieved at shorter terms, no tenolysis was required and one-step tenoplasty could be performed instead of two-step reconstruction.

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About the authors

Yu. M Chernyakova

Gomel State Medical University

Email: ychernyakova72@mail.ru
Gomel, Belarus’

References

  1. Золотов А.С. Первичный шов сухожилий сгибателей пальцев кисти в разных анатомических зонах. Пластическая хирургия. 2012; 41 (2): 19-25.
  2. Страфун С.С., Куринной И.Н., Безуглый А.А., Черенок Е.П., Хименко С.А. Хирургия сухожилий пальцев кисти. Киев: Макрос; 2012.
  3. Dy C.J., Daluiski A., Do H.T. et al. The epidemiology of reoperation after flexor tendon repare. J. Hand Surg. Am. 2012; 37 (5): 919-24.
  4. Чернякова Ю.М., Дорошкевич О.С. Несостоятельность первичного шва сухожилий сгибателей пальцев кисти. В кн.: Материалы научно-практической конференции «Развитие травматологии и ортопедии на современном этапе». Гродно; 2016: 118-20.
  5. Байтингер В.Ф. Клиническая анатомия «ничейной зоны» (no man’s land). Вопросы реконструктивной и пластической хирургии. 2010; 11 (2): 18-26.
  6. Kleinert H.E., Kutz J.E., Ashbell T.S., Marinez E. Primary repair of lacerated flexor tendons in no-man’s land (abstract). J. Bone Joint Surg. 1967; 49A: 577.
  7. Lundborg G., Rank F. Experimental intrinsic healing of flexor tendons based upon synovial fluid nutrition. J. Hand Surg. Am. 1978; 3 (1): 21-31.
  8. Manske P.R., Gelberman R.H., Lesker P.A. Flexor tendon healing. Hand Clin. 1985; 1 (1): 25-34.
  9. Ломая М.П. Двухэтапная тендопластика при застарелых повреждениях сухожилий сгибателей пальцев кисти с применением активных силиконовых сухожильных эндопротезов. Травматология и ортопедия России. 2007; 45 (3): 68-72.
  10. Tsuge K., Ikuta Y., Matsuishi Y. Repair of flexor tendons by intratendinous tendon suture. J. Hand. Surg. Am. 1977; 2 (6): 436-40.
  11. Green D., Hotchkiss R., Pederson W., Wolfe S. Green’s Operative Hand Surgery. 5th ed. NY: Churchill Livingstone; 2005.

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