Two-Staged Reconstruction of the Flexor Pollicis Longus Tendon

2006 ◽  
Vol 31 (4) ◽  
pp. 432-435 ◽  
Author(s):  
F. UNGLAUB ◽  
C. BULTMANN ◽  
A. REITER ◽  
P. HAHN
Keyword(s):  
Range Of Motion ◽  
Primary Repair ◽  
Tendon Graft ◽  
Dash Score ◽  
Flexor Pollicis Longus ◽  
Two Stage ◽  
Active Range Of Motion ◽  
Flexor Pollicis Longus Tendon ◽  
Staged Reconstruction ◽  
The Ideal

The purpose of this study was to evaluate the results of two-stage reconstruction of the flexor pollicis longus (FPL) tendon. Sixteen patients who underwent reconstructive surgery of the FPL tendon were assessed retrospectively. Eight weeks after implantation of a silastic spacer, a tendon graft was used for reconstruction (thirteen palmaris longus tendons, two plantaris tendons, one half of the flexor carpi radialis tendon). Power grip, active range of motion, passive range of motion, the Buck-Gramcko assessment, the ASSH assessment and the DASH score were used to evaluate the results. Adequate function in 75% of the cases and a median of 11 on the DASH score was achieved. The results showed that two-stage reconstruction of the FPL tendon can produce satisfactory results, even if primary repair is the ideal.

Early Active Mobilization of Primary Repairs of the Flexor Pollicis Longus Tendon with Two Kessler Two-Strand Core Sutures and a Strengthened Circumferential Suture

2004 ◽  
Vol 29 (6) ◽  
pp. 531-535 ◽  
Author(s):  
M. SIROTAKOVA ◽  
D. ELLIOT
Keyword(s):  
Primary Repair ◽  
Early Mobilization ◽  
Flexor Pollicis Longus ◽  
Longus Tendon ◽  
Active Mobilization ◽  
Flexor Pollicis Longus Tendon

This study reports our treatment of divided flexor pollicis longus (FPL) tendons by primary repair from 1999 to 2002. Forty-eight FPL repairs were performed using two Kessler two-strand repairs with a cross-linked Silfverskiöld circumferential suture. All were rehabilitated by early active mobilization. Excellent or good results were observed in 73/77% of cases (White/Buck–Gramcko assessments, respectively). No patients (0%) ruptured their repair as a result of early active mobilization. Two patients (4%) developed post-operative infections with wound and tendon dehiscence. This combination of repairs addresses the problem of rupture of FPL during early mobilization which we experienced in previous studies. Its problems and alternatives are discussed.

“I-P Flexor Lag” after Thumb Flexor Reconstruction — Causes and Solution

HAND ◽  
1980 ◽  
Vol os-12 (2) ◽  
pp. 167-172 ◽  
Author(s):  
David B. Apfelberg ◽  
Morton R. Maser ◽  
Harvey Lash ◽  
Leo Keoshian
Keyword(s):  
Range Of Motion ◽  
Flexor Pollicis Longus ◽  
Reconstructive Procedures ◽  
Significant Percentage ◽  
Longus Tendon ◽  
Flexor Pollicis Longus Tendon

A small but significant percentage of thumbs fail to regain complete range of motion after reconstructive procedures designed to replace lost function of the flexor pollicis longus tendon. A characteristic but little noted posture and attitude of metacarpophalangeal flexion with loss of interphalangeal motion and metacarpophalangeal stabilisation with restoration of interphalangeal motion is described. (“I-P flexion lag”—I.P.F.L.) Clinical causes include shortening of the muscle-tendon unit, loss of pulleys with bowstringing, adhesions and hypermobile joints.

Rupture of Flexor Pollicis Longus as a Complication of Colles’ Fracture: A Case Report

1990 ◽  
Vol 15 (3) ◽  
pp. 370-372
Author(s):  
J. O. ROBERTS ◽  
P. J. REGAN ◽  
A. H. N. ROBERTS
Keyword(s):  
Case Report ◽  
Tendon Rupture ◽  
Functional Result ◽  
Tendon Repair ◽  
Tendon Graft ◽  
Flexor Pollicis Longus ◽  
Good Functional Result ◽  
Longus Tendon ◽  
Colles Fracture ◽  
Flexor Pollicis Longus Tendon

A case of flexor pollicis longus tendon rupture as a complication of a Colles’ fracture in a 17-year-old male is described. Tendon repair by means of a one-stage tendon graft produced a good functional result.

Flexor pollicis longus primary repair: further experience with the tang technique and controlled active mobilization

2009 ◽  
Vol 34 (6) ◽  
pp. 758-761 ◽  
Author(s):  
T. GIESEN ◽  
M. SIROTAKOVA ◽  
A. J. COPSEY ◽  
D. ELLIOT
Keyword(s):  
Primary Repair ◽  
Pain Syndrome ◽  
Syndrome Type ◽  
Flexor Pollicis Longus ◽  
Postoperative Infections ◽  
Longus Tendon ◽  
Chronic Regional Pain Syndrome ◽  
Active Mobilization ◽  
Flexor Pollicis Longus Tendon

This study reports our treatment of divided flexor pollicis longus tendons by primary repair from January 2004 to September 2007. Fifty flexor pollicis longus repairs carried out using the Tang technique of three Tsuge sutures are reported in this study. A circumferential suture was not used routinely. Excellent or good results were observed in 78/82% of cases (White/Buck-Gramcko assessments, respectively). No patients ruptured repairs as a result of early active mobilization. No patients developed postoperative infections with wound and tendon dehiscence. One patient developed Chronic Regional Pain Syndrome Type 1. We have found this repair of the flexor pollicis longus tendon to be safe for early active mobilization and it is easier to perform than primary repair of this tendon using four strand Kessler-type core sutures and elaborate circumferential sutures, as reported previously.

scholarly journals Operative treatment of flexor pollicis longus tendon with Krackow suture, functional results: Preliminary results

2010 ◽  
Vol 57 (4) ◽  
pp. 15-17
Author(s):  
Marko Bumbasirevic ◽  
Sladjana Andjelkovic ◽  
Aleksandar Lesic ◽  
Vojo Sudjic ◽  
Tomislav Palibrk ◽  
...  
Keyword(s):  
Operative Treatment ◽  
Functional Recovery ◽  
Hand Surgery ◽  
Functional Results ◽  
Metacarpophalangeal Joint ◽  
Suture Technique ◽  
Dash Score ◽  
Flexor Pollicis Longus ◽  
Flexor Pollicis Longus Tendon ◽  
Krackow Suture

INTRODUCTION: Surgical treatment of the injuried flexor tensons is the important part of hand surgery. Tendon adhesions, ruptures, joint contcatures-stifness are only one part of the problem one is faced during the tendon treatment. In spite of improvement in surgical technique and suture material, the end result of sutured flexor tendons still represent a serious problem. THE AIM of study is to present of operative treatment of flexor pollicis longus injury with Krakow suture technique. METHODS. All patients are treated in the first 48 hours after the accident. The regional anesthesia was performed with use of turniquet. Beside spare debridement, the reconstruction of digital nerves was done. All patients started with active and pasive movements-excercises on the first postoperative day. Follow-up was from 6 to 24 months. In evaluation of functional recovery the grip strenght, pinch strenght, range of movements of interphalangeal and metacarpophalangeal joint and DASH score were used. RESULTS. In the last two years there were 30 patients, 25 males (83.33%) and 5 females (16.66%). Mean age was 39.8 years, ranged from 17 to 65 years. According to mechanism of injury the patients were divided in two groups: one with sharp and other with wider zone of injury. Concomitant digital nerve lesions was noticed in 15 patients (50%). CONCLUSION. The Krackow suture allowed early rehabilitation, which prevent tendon adhesions, enabled faster and better functional recovery.

CLOSED TRAUMATIC RUPTURE OF THE FLEXOR POLLICIS LONGUS TENDON IN ZONE T I: A CASE REPORT

Hand Surgery ◽  
2015 ◽  
Vol 20 (01) ◽  
pp. 145-147 ◽  
Author(s):  
Kazuaki Uekubo ◽  
Soichiro Itoh ◽  
Taro Yoshioka
Keyword(s):  
Case Report ◽  
Range Of Motion ◽  
Functional Recovery ◽  
Distal Phalanx ◽  
Traumatic Rupture ◽  
Flexor Pollicis Longus ◽  
Pull Out ◽  
Motion Exercise ◽  
Flexor Pollicis Longus Tendon ◽  
Distal Tendon

A healthy 41-year-old male suffered a direct blow on the palmar side of his right thumb when folding a table, which slipped along his thumb until it was stopped at the inter-phalangeal (IP) joint, resulting in a complete rupture of the flexor pollicis longus (FPL) tendon in zone T I. The proximal tendon stump was passed through the oblique pulley, fixed to the base of the distal phalanx with a pull-out wire technique and augmented on it using a part of the distal tendon remnant. After removal of the cast and the pull-out wire three weeks postoperatively, range of motion exercise was initiated and good functional recovery was obtained.

Closed Rupture of the Flexor Tendons Caused by Carpal Bone and Joint Disorders

2007 ◽  
Vol 32 (6) ◽  
pp. 649-653 ◽  
Author(s):  
H. YAMAZAKI ◽  
H. KATO ◽  
Y. HATA ◽  
Y. NAKATSUCHI ◽  
A. TSUCHIKANE
Keyword(s):  
Range Of Motion ◽  
Carpal Tunnel ◽  
Flexor Tendon ◽  
Tendon Graft ◽  
Interphalangeal Joint ◽  
Carpal Bone ◽  
Flexor Tendons ◽  
Closed Rupture ◽  
Active Range Of Motion ◽  
Graft Reconstruction

We analysed 21 patients with closed rupture of the flexor tendons caused by carpal bone and joint disorders. The tendon that ruptured depended on the location of the bone perforation into the carpal tunnel. Radiocarpal arthrography was performed in 13 patients and capsular perforation was demonstrated by contrast medium leakage into the carpal canal in 11 patients. This proved a useful diagnostic test. The flexor tendon(s) were reconstructed with free tendon graft in 17 patients, crossover transfer of flexor tendons from adjacent digits in two and buddying to an adjacent flexor tendon in one patient. Postoperative total active range of motion in the fingers after 13 free tendon graft reconstructions averaged 213° (range 170–265°). The active range of motion of the thumb-interphalangeal joint after free tendon graft reconstruction in three cases improved from 0° to 33° on average (range 10°–40°).

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