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Background
Flexor tendon rupture is a rare but major complication associated with volar plate fixation of distal radius fractures.Materials and methods
We performed a systematic review to evaluate the demographics, clinical profile, treatment and outcome of flexor tendon rupture following volar plate fixation of distal radius fracture. Electronic searches of the MEDLINE, EMBASE, and Cochrane databases for systematic reviews and conference proceedings were performed. Studies were included if they reported flexor tendon rupture (partial or complete) as a complication of distal radius fracture plating (all levels of evidence).Result
Our search yielded 21 studies. There were 12 case reports and 9 clinical studies. A total of 47 cases were reported. There were 11 males and 23 females (n = 16 studies). The mean age was 61 years old (range 30–85). The median interval between the surgery and flexor tendon rupture was 9 months (interquartile range, 6–26 months). Twenty-nine plates were locking and 15 were nonlocking (n = 20 studies). FPL was the most commonly ruptured tendon (n = 27 cases, 57 %), with FDP to index finger being the second most common (n = 7 cases, 15 %). Palmaris longus tendon graft and primary end-to-end repair were the most common surgical methods used in cases of FPL tendon rupture.Conclusion
Flexor tendon rupture is a recognised complication of volar plating of distal radius fracture. Positioning of the plate proximal to the “watershed” line and early removal of the plate in cases with plate prominence or warning symptoms can reduce the risk of this complication. 相似文献3.
Although extensor pollicis longus tendon ruptures have been noted as a complication of distal radius fractures, flexor tendon ruptures in association with acute fractures of the distal radius are rare. We report a rupture of the flexor carpi radialis tendon as a complication of an acute distal radius fracture that was discovered during operative management of the fracture. 相似文献
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Mohammed Heshmat Abdul-Kader Mahmound A. M. Amin 《Indian Journal of Plastic Surgery》2010,43(1):14-20
We report the results of staged flexor tendon reconstruction in 12 patients (12 fingers) with neglected or failed primary repair of flexor tendon injuries in zone II. Injuries involved both flexor digitorum profundus (FDP) and flexor digitorum sublimis (FDS), with poor prognosis (Boyes grades II–IV). The procedure included placing a silicone rod and creating a loop between the FDP and FDS in the first stage and reflecting the latter as a pedicled graft through the pseudosheath created around the silicone rod in the second stage. At a mean follow-up of 18 months (range 12–30 months), results were assessed by clinical examination and questionnaire. The mean total active motion of these fingers was 188°. The mean power grip was 80.0% and pinch grip was 76% of the contralateral hand. The rate of excellent and good results was 75% according to the Buck-Gramcko scale. These results were better than the subjective scores given by the patients. Complications included postoperative hematoma in two, infection in one, silicone synovitis in one (after stage I) and three flexion contractures after stage II. This study confirmed the usefulness of two-stage flexor tendon reconstruction using the combined technique as a salvage procedure to restore flexor tendon function with a few complications. 相似文献
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Nikolaos Anastasopoulos George Paraskevas Nikolaos Lazaridis Konstantinos Natsis 《The Journal of foot and ankle surgery》2018,57(6):1256-1258
Isolated rupture of the flexor hallucis longus tendon is an unusual injury. We present the case of a neglected flexor hallucis longus tendon closed traumatic rupture at the plantar aspect of the first phalangeal head of the great toe in a middle-age male. The injury occurred while he was dancing. Because end-to-end tendon suture was impossible, the ensuing gap was repaired using a free plantaris tendon graft. We present the operative repair benefit of the flexor hallucis longus tendon rupture to regain the function and strength of the interphalangeal joint of the hallux, avoid extension of the distal phalanx, and maintain the longitudinal arch of the foot. 相似文献
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应用(足母)长屈肌腱加用跖肌腱加固重建陈旧性跟腱断裂 总被引:1,自引:1,他引:0
1999年6月-2004年3月采用(足母)长屈肌腱(FHL)加用跖肌腱加固治疗陈旧性跟腱断裂13例,现报告如下。 相似文献
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1999年6月-2004年3月采用长屈肌腱(FHL)加用跖肌腱加固治疗陈旧性跟腱断裂13例,现报告如下。1临床资料本组13例,男10例,女3例;年龄23~57岁,平均37·4岁;左侧8例,右侧5例;病程28~147d,平均78d。致伤原因:运动伤11例,切割伤2例。4例经手术修复后再断裂。伤后未处理1例。临床表现:13例均主诉踝跖屈提踵无力,其中8例足跟痛,跛行。体检:跟腱断裂处凹陷,Thompsom试验9例阳性,3例可疑,1例阴性。对可疑者行MRI检查。2手术方法手术采用硬膜外麻醉,俯卧,在气压止血带下进行。沿跟腱内侧S形切口,显露跟腱断端及跖肌腱。术中见残端均为瘢痕组织,充… 相似文献
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Spontaneous flexor tendon rupture of the flexor digitorum profundus secondary to an anatomic variant
We report a case of the flexor digitorum profundus tendon rupture of the little finger, which was predisposed by an anatomic variation of the tendon. Intraoperative findings and magnetic resonance imaging of the opposite hand suggested that the flexor digitorum profundus tendons of the ring and the little finger bifurcated. The patient had tendon reconstruction and regained function. We believe that reconstructing the tendon so that it resembles the normal anatomy prevents the recurrence of tendon rupture. 相似文献
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《Foot and Ankle Surgery》2020,26(6):607-613
BackgroundThe flexor hallucis longus (FHL) muscle often has a tendinous slip with a variable number of branches. We aimed at developing the FHL branch test to determine the number of FHL branches.MethodsIn anatomical validation study, 6 intact cadavers were used. The toe flexion angles were measured while the FHL and flexor digitorum longus (FDL) were manually pulled individually. For electrophysiological studies, 4 healthy men participated. The FHL was electrically stimulated, and electromyography (EMG) of the FHL and FDL were recorded during the FHL branch test.ResultsThe toe flexion angles’ changes in the FHL pulling condition were equivalent with pulling FDL in toes with FHL branching. The electrical stimulation of the FHL produced similar flexion as the FHL branch test. EMG of the FHL was higher than FDL during the FHL branch test (p = 0.036).ConclusionsThe FHL branch test could be used to evaluate the number of FHL branches. 相似文献
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Flexor tendon repair in vitro: a comparative histologic study of the rabbit, chicken, dog, and monkey 总被引:3,自引:0,他引:3
R H Gelberman P R Manske J S Vande Berg P A Lesker W H Akeson 《Journal of orthopaedic research》1984,2(1):39-48
Flexor tendon healing in four different animal species was explored in a tissue culture system. Ninety percent transverse lacerations were made in 88 tendon segments obtained from rabbits, chickens, dogs, and monkeys. The tendons were removed from culture and studied by light and electron microscopy at intervals of 3, 6, 9, and 12 weeks. A characteristic sequence of repair including epitenon thickening, cellular differentiation, cell migration, and phagocytosis was seen in each of the repaired tendons. The endotenon cells of several animal tendons appeared to be synthesizing collagen. There was a consistent difference in the rate of healing between the four species. The rabbit tendons demonstrated nearly complete closure of the repair site by 12 weeks. A lesser response was seen in the chicken, followed by the dog and monkey. The differences in healing rate appeared to be due to the non-species-specific in vitro culture media. The in vitro flexor tendon culture system is particularly useful in studying the tendon repair responses of various species with the contributions of vascularity and synovial cells excluded. 相似文献
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Miller B Dodds SD deMars A Zagoreas N Waitayawinyu T Trumble TE 《The Journal of hand surgery》2007,32(5):591-596
PURPOSE: Immediate surgical repair and early mobilization are essential in preventing adhesion formation and finger stiffness. A new polyethylene-based, braided suture material, Fiberwire (Arthrex, Naples, FL), touting increased strength, presents the potential for stronger repairs and, therefore, earlier active motion after surgery with a greater safety margin. The purpose of this biomechanic study was to investigate the differences in gap formation, tensile strength, and mode of failure for 2 distinct repair techniques using nylon, Ethibond (Ethicon, Somerville, NJ), and Fiberwire. METHODS: Human cadaver flexor tendons were harvested and repaired in a randomized fashion with either the Strickland or Massachusetts General Hospital (MGH) repairs using either nylon, Ethibond, or Fiberwire. Twelve tendons per group were repaired for each combination of material and method. During load-to-failure testing, 2-mm gap force and maximum tensile strength were statistically analyzed. RESULTS: Strickland repairs failed by suture pull-out in 74% of repairs, whereas 99% of the MGH repairs failed by suture breakage. For MGH repairs, Fiberwire suture provided significantly more tensile strength than Ethibond and nylon. For Strickland repairs, where the mode of failure was more often by suture pull-out rather than breakage, differences between type of suture were not significant. When comparing repair techniques using Fiberwire, the MGH repair was significantly stronger than the Strickland repair. CONCLUSIONS: Biomechanic testing shows that Fiberwire outperforms both Ethibond and nylon suture when using a locked flexor tendon repair suture (MGH repair) but not when using a grasping-type, nonlocking repair (Strickland repair). 相似文献
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Yasuhiro Ozasa Takuro Wada Kousuke Iba Toshihiko Yamashita 《Acta orthopaedica et traumatologica turcica》2018,52(4):323-325
We report a case of a partial rupture of the distal biceps tendon that was surgically treated using a palmaris longus tendon graft. A 58-year-old man complained of increasing pain with resisted elbow flexion and supination in the antecubital fossa. Magnetic resonance imaging revealed the irregularity of a distal attachment of the biceps brachii and peripheral signal changes. We diagnosed a partial rupture of the distal biceps tendon. Because conservative treatment failed, surgical treatment was performed through a single anterior approach. The insertion of the tendon was partially ruptured at the radial tuberosity. After the involved site was debrided, the palmaris longus tendon was grafted with suture anchors to reinforce the remaining tendon. Postoperative immobilization was not performed, and all moves were freed after 3 weeks. At the 6-year postoperative follow-up, the patient no longer experienced pain and returned to his original job without any limitations. 相似文献
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Lorenzo Rocchi Antonio Merolli Andrea Genzini Gianfranco Merendi Francesco Catalano 《Journal of orthopaedics and traumatology》2008,9(4):201-208
Background Recently, the Teno FixTM device has been detailed in the literature. Conventional stranded cruciate repair requires splinting to protect the sutures
from excessive loading, and then, active motion is strongly limited leading to a possible incomplete functional recovery.
Materials and methods The authors report on their experience in treating 21 patients presenting primary flexor tendon injuries within the digital
sheath in zone 2, in all fingers (including the thumb), at an average follow-up of 16 (range: 6–26) months.
Results There were, according to Strickland and Glogovac criteria: 12 excellent; 6 good; 3 fair.
Conclusions This new device is practical clinically and can effect strong tendon repairs that withstand early active finger motion, but
the best indication is to treat only selected cases of sharp flexor tendon lesions in zone 2. Using this technique it is possible
to achieve a quick functional recovery and early return to work. 相似文献
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微创切取长屈肌腱重建慢性跟腱断裂 总被引:1,自引:0,他引:1
目的探讨微创切取长屈肌腱转移重建慢性跟腱断裂的临床效果。方法 2006年7月-2009年12月,收治22例22足慢性跟腱断裂患者。男16例,女6例;年龄28~65岁,中位年龄48岁。21例有患足用力蹬地史,1例无明显诱因。患者出现症状至手术时间为27~1 025 d,中位时间51 d。均有走路无力症状,Thompson试验呈阳性。根据美国矫形足踝协会(AOFAS)踝与后足疗效评价标准评分为(53.04±6.75)分。MRI示跟腱缺损长度为4.2~8.0 cm。术中作中足足底内侧切口和趾间关节跖侧平行横纹的小切口分步切取长屈肌腱,切取长度为超过跟骨结节10.5~13.5 cm,作3束反折编织缝合。界面螺钉或锚钉于跟骨后结节固定肌腱。结果术后患者切口均Ⅰ期愈合,无早期并发症发生。22例均获随访,随访时间12~42个月,平均16.7个月。术后12个月根据AOFAS踝与后足疗效评价标准评分为(92.98±5.72)分,与术前比较差异有统计学意义(t=—40.903,P=0.000);获优18例,良2例,可2例,优良率90.9%。随访期间均未见胫、腓肠神经损伤、跖底部痛性瘢痕、足底内外侧神经损伤。结论微创切取长屈肌腱转移重建慢性跟腱断裂具有切口小、术后恢复快、肌腱固定强度高以及并发症少的优点。 相似文献