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Wide-Awake Primary Flexor Tendon Repair, Tenolysis, and Tendon Transfer.

Tang JB - Clin Orthop Surg (2015)

Bottom Line: This method allows the tendon to move actively during surgery to test tendon function intraoperatively and to ensure the tendon is properly repaired before leaving the operating table.I applied this method to primary flexor tendon repair in zone 1 or 2, tenolysis, and tendon transfer, and found this approach makes tendon surgery easier and more reliable.This article describes the method that I have used for tendon surgery.

View Article: PubMed Central - PubMed

Affiliation: Department of Hand Surgery, The Hand Surgery Research Center, Affiliated Hospital of Nantong University, Nantong, China.

ABSTRACT
Tendon surgery is unique because it should ensure tendon gliding after surgery. Tendon surgery now can be performed under local anesthesia without tourniquet, by injecting epinephrine mixed with lidocaine, to achieve vasoconstriction in the area of surgery. This method allows the tendon to move actively during surgery to test tendon function intraoperatively and to ensure the tendon is properly repaired before leaving the operating table. I applied this method to primary flexor tendon repair in zone 1 or 2, tenolysis, and tendon transfer, and found this approach makes tendon surgery easier and more reliable. This article describes the method that I have used for tendon surgery.

No MeSH data available.


Related in: MedlinePlus

After flexor digitorum profundus tendon repair, the patient actively extended and flexed the finger to perform the extension-flexion test. The photo shows active extension of the repaired digit without gapping at the repair site.
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Figure 6: After flexor digitorum profundus tendon repair, the patient actively extended and flexed the finger to perform the extension-flexion test. The photo shows active extension of the repaired digit without gapping at the repair site.

Mentions: There are thee needed parts of this test: (1) full active extension to verify no gapping between the tendon ends (Fig. 6); (2) smooth active flexion to verify smooth gliding of the tendon and its repair site; and (3) active flexion to almost totally flex the digit to verify that the no pulley prevents tendon gliding. If the examination creates a visible gap between the two tendon ends during finger extension, the suture is usually not tight enough and needs to be replaced with a tighter suture with proper tension to avoid rupture. Active flexion indicates the annular pulley prevents ample gliding of the tendon. Pulleys may need to be vented further.


Wide-Awake Primary Flexor Tendon Repair, Tenolysis, and Tendon Transfer.

Tang JB - Clin Orthop Surg (2015)

After flexor digitorum profundus tendon repair, the patient actively extended and flexed the finger to perform the extension-flexion test. The photo shows active extension of the repaired digit without gapping at the repair site.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4553273&req=5

Figure 6: After flexor digitorum profundus tendon repair, the patient actively extended and flexed the finger to perform the extension-flexion test. The photo shows active extension of the repaired digit without gapping at the repair site.
Mentions: There are thee needed parts of this test: (1) full active extension to verify no gapping between the tendon ends (Fig. 6); (2) smooth active flexion to verify smooth gliding of the tendon and its repair site; and (3) active flexion to almost totally flex the digit to verify that the no pulley prevents tendon gliding. If the examination creates a visible gap between the two tendon ends during finger extension, the suture is usually not tight enough and needs to be replaced with a tighter suture with proper tension to avoid rupture. Active flexion indicates the annular pulley prevents ample gliding of the tendon. Pulleys may need to be vented further.

Bottom Line: This method allows the tendon to move actively during surgery to test tendon function intraoperatively and to ensure the tendon is properly repaired before leaving the operating table.I applied this method to primary flexor tendon repair in zone 1 or 2, tenolysis, and tendon transfer, and found this approach makes tendon surgery easier and more reliable.This article describes the method that I have used for tendon surgery.

View Article: PubMed Central - PubMed

Affiliation: Department of Hand Surgery, The Hand Surgery Research Center, Affiliated Hospital of Nantong University, Nantong, China.

ABSTRACT
Tendon surgery is unique because it should ensure tendon gliding after surgery. Tendon surgery now can be performed under local anesthesia without tourniquet, by injecting epinephrine mixed with lidocaine, to achieve vasoconstriction in the area of surgery. This method allows the tendon to move actively during surgery to test tendon function intraoperatively and to ensure the tendon is properly repaired before leaving the operating table. I applied this method to primary flexor tendon repair in zone 1 or 2, tenolysis, and tendon transfer, and found this approach makes tendon surgery easier and more reliable. This article describes the method that I have used for tendon surgery.

No MeSH data available.


Related in: MedlinePlus