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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

Postoperative motion: full passive digital flexion (A) is done first, followed by partial active motion (B) in the first 3 weeks.
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Figure 7: Postoperative motion: full passive digital flexion (A) is done first, followed by partial active motion (B) in the first 3 weeks.

Mentions: The early active motion that I use is a combined passive-active motion, starting from 3 to 5 days after the surgery.15) I do not move the operated digits in the first 3 days after surgery because edema is prominent, pain is severe, and adhesions do not form in this period. Motion starts from day 4 or 5. In the initial 1 to 2 weeks after surgery, we keep the active finger flexion within only one-third of the total range of finger motion (Fig. 7). The partial range of active motion is progressively increased to two-thirds in week 3 or 4 after surgery. The patient should avoid full range of active flexion in the first 2 to 3 weeks after surgery because the final extreme digital flexion produces the greatest bending force to the tendon and tendon is prone to disruption. Full range of active motion starts at week 4. I sometimes start full active motion even a little later in the patient who had tendon repairs in multiple fingers, or when the tendon is repaired 3 to 5 weeks after trauma or after repair of ruptured primary repair.


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

Tang JB - Clin Orthop Surg (2015)

Postoperative motion: full passive digital flexion (A) is done first, followed by partial active motion (B) in the first 3 weeks.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 7: Postoperative motion: full passive digital flexion (A) is done first, followed by partial active motion (B) in the first 3 weeks.
Mentions: The early active motion that I use is a combined passive-active motion, starting from 3 to 5 days after the surgery.15) I do not move the operated digits in the first 3 days after surgery because edema is prominent, pain is severe, and adhesions do not form in this period. Motion starts from day 4 or 5. In the initial 1 to 2 weeks after surgery, we keep the active finger flexion within only one-third of the total range of finger motion (Fig. 7). The partial range of active motion is progressively increased to two-thirds in week 3 or 4 after surgery. The patient should avoid full range of active flexion in the first 2 to 3 weeks after surgery because the final extreme digital flexion produces the greatest bending force to the tendon and tendon is prone to disruption. Full range of active motion starts at week 4. I sometimes start full active motion even a little later in the patient who had tendon repairs in multiple fingers, or when the tendon is repaired 3 to 5 weeks after trauma or after repair of ruptured primary repair.

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