Search Results (3)

Objective: Managing flexor tendon injuries surgically remains challenging due to the ongoing debate over the most effective suture technique and materials. An optimal repair must be technically feasible while providing enough strength to allow for early active mobilization during the post-operative phase. This study aimed to assess the biomechanical properties of three modified Kessler repair techniques using two different suture materials: a conventional two-strand and a modified four-strand Kirchmayr–Kessler repair using 3-0 Prolene^® (2s-KK-P and 4s-KK-P respectively), and a four-strand Kessler–Tsuge repair using 4-0 FiberLoop^® (4s-KT-FL). Methods: Human flexor digitorum profundus (FDP) tendons were retrieved from Thiel-embalmed prosections. For each tendon, a full-thickness cross-sectional incision was created, and the ends were reattached using either a 2s-KK-P (n = 30), a 4s-KK-P (n = 30), or a 4s-KT-FL repair (n = 30). The repaired tendons were tested using either a quasi-static (n = 45) or cyclic testing protocol (n = 45). Maximum force (F_max), 2 mm gap force (F_2mm), and primary failure modes were recorded. Results: In both quasi-static and cyclic testing groups, tendons repaired using the 4s-KT-FL approach exhibited higher F_max and F_2mm values compared to the 2s-KK-P or 4s-KK-P repairs. F_max was significantly higher with a 4s-KK-P versus 2s-KK-P repair, but there was no significant difference in F_2mm. Suture pull-out was the main failure mode for the 4s-KT-FL repair, while suture breakage was the primary failure mode in 2s- and 4s-KK-P repairs. Conclusions: FDP tendons repaired using the 4s-KT-FL approach demonstrated superior biomechanical performance compared to 2s- and 4s-KK-P repairs, suggesting that the 4s-KT-FL tendon repair could potentially reduce the risk of gapping or re-rupture during early active mobilization. Full article

The purpose of this report is to describe the technique and the clinical outcome of three dogs affected by superficial digital flexor (SDF) tendon luxation treated using a calcaneal chondroplastic-like technique. A German Pinscher with bilateral and lateral SDF tendon luxation, a Griffon Nivernais with medial SDF tendon luxation following self-mutilation of the IV toe, and an American Staffordshire Terrier with a lateral luxation and having undergone calcaneal chondroplasty and primary repair of the retinacular tissues. A fibrocartilage flap covering the calcaneal groove was elevated, the subchondral bone was removed from beneath it, and the flap was pressed back into the deepened sulcus, keeping its distal attachment as a hinge point. The SDF tendon was reduced, and its tracking along the deepened groove was ensured. Furthermore, the torn retinacular attachment was repaired. Clinical follow-ups at 4 and 8 weeks and 1 year apart showed no signs of lameness and no SDF tendon re-luxation. The calcaneal chondroplastic-like technique led to a satisfactory outcome with no complications. This technique is relatively straightforward, requires no implants, and is also successful without postoperative immobilization of the tarsal joint. Further cases are required to determine its benefits and its risks compared to conventional surgery. Full article

Purpose:Our hypothesis was that the rupture rate after primary flexor tendon repair in the modified 4-strand core suture technique using the FiberLoop^® (Arthrex, Munich, Germany) is lower than in other suture materials and functional outcome and patient satisfaction are superior compared to the current literature. Patients and methods: A 2-stage retrospective, randomized follow-up study of 143 patients treated with the Arthrex FiberLoop^® after flexor tendon injury in zones 2 or 3 from May 2013 to May 2017 was performed. In the 1^st stage, the rupture rate of all patients was assessed after a follow-up of at least one year by interview to exclude revision surgery. In the 2nd stage, 20% of the patients could be randomly clinically examined. Functional parameters, such as finger and wrist range of motion measured by goniometer, grip strength measured by Jamar dynamometer (Saehan, South Korea), patient satisfaction measured by school grades (1–6), pain levels measured by visual rating scales (0–10) and functional outcome according to the DASH-score were assessed. The Buck-Gramcko and Strickland scores were calculated. The length of sick leave was recorded. Results: A rupture rate of 2.1% was recorded. 29 patients (20%) were followed up at a mean of 34 ± 7.5 months postoperatively. 10.3% of these patients had an incomplete fingertip palm distance. The mean postoperative grip strength was 24 ± 3.1 kg. 93% of the patients were very satisfied with the treatment. No patient complained of pain postoperatively. The mean postoperative DASH score was 6.7 ± 2.8 points. The mean Buck-Gramcko score was 14 ± 0.2 points. 93% of the patients had excellent and 7% good results according to the Strickland score. 67% of patients had a work accident and returned to work at a mean of 4 ± 0.2 months postoperatively. 31% of patients suffered a non-occupational injury and returned to work at a mean of 3 ± 0.4 months postoperatively. Conclusions: Primary flexor tendon repair in the modified 4-strand core suture technique using the Arthrex FiberLoop^® has proven to be a viable treatment option in our series. The rupture rate was lower than in other suture materials. It leads to acceptable pain relief, grip strength and functional outcome. Level of Evidence: IV; therapeutic. Full article