Early Breaking Strength of Repaired Flexor Tendon Treated with 5-Fluorouracil

2001 ◽  
Vol 26 (3) ◽  
pp. 220-223 ◽  
Author(s):  
S. CEROVAC ◽  
A. AFOKE ◽  
A. AKALI ◽  
D. A. McGROUTHER
Keyword(s):  
Tensile Strength ◽  
Normal Saline ◽  
Tensile Testing ◽  
Matched Control ◽  
Flexor Tendon ◽  
Breaking Strength ◽  
Adhesion Formation ◽  
Flexor Tendons ◽  
And Control

This study investigated the effect of a single intraoperative application of 5-fluorouracil, which may diminish peritendinous adhesion formation, on the tensile strength of repaired digital flexor tendons after 7, 14 and 21 days of healing. Twenty-seven deep flexor tendons from 14 rabbits were exposed to 5-fluorouracil (50 mg/ml) for 5 minutes immediately after repair whereas matched control tendons were exposed to normal saline. Tensile testing at 7, 14 and 21 days revealed no significant differences in the gap or ultimate strengths of the 5-fluorouracil treated and control tendons.

The Effect of Suture Materials on the Biomechanical Performance of Different Flexor Tendon Repairs and the Concept of Construct Efficiency

2018 ◽  
Vol 23 (02) ◽  
pp. 243-247
Author(s):  
Yoke Rung Wong ◽  
Austin Mun Kitt Loke ◽  
Shian Chao Tay
Keyword(s):  
Tensile Strength ◽  
Ultimate Tensile Strength ◽  
Tensile Testing ◽  
Flexor Tendon ◽  
Experimental Results ◽  
Suture Materials ◽  
Nylon Suture ◽  
Biomechanical Strength ◽  
Repair Techniques

Background: To propose a new term (‘construct efficiency’) for the evaluation of multi strands flexor tendon repairs using different suture materials. Methods: A total of twenty specimens from 4-0 braided polyblend sutures (FiberLoop/FiberWire; Arthrex, Naples, FL) and 4-0 nylon sutures (Supramid Extra II; S. Jackson, Inc., Alexandria, VA) were subjected to tensile testing using Pneumatic Cord-and-Yarn Grips (Instron Corp., Canton MA, USA). The ultimate tensile strengths of the suture materials were measured. The expected repair strengths and construct efficiencies were computed based on the experimental results and from available literature on actual repair strengths of the 4-strand Becker, Cruciate repairs and 6-strand Tang, modified Lim-Tsai repairs. Results: The ultimate tensile strength of nylon suture was 15.4 ± 0.6N, lower than that of braided polyblend suture (45.3 ± 2.3N) with a difference of 194%. The construct efficiency of multi strand repairs varied with respect to different repair techniques and suture materials. It was found that the Becker repairs using FiberWire had the highest construct efficiency (55.7%) followed by the modified Lim-Tsai using Supramid (50.9%), Tang repair using Supramid (49.8%), Cruciate repair using Fiberwire (49.1%), and modified Lim-Tsai repair using FiberLoop (33.5%). Conclusions: The construct efficiency is more accurate in showing that, in terms of biomechanical strength, the use of FiberWire for the 4-strand Becker and Cruciate repair is more efficient than that of using FiberLoop for 6-strand modified Lim-Tsai repair.

A TECHNIQUE FOR PORCINE FLEXOR TENDON HARVEST

2006 ◽  
Vol 10 (04) ◽  
pp. 181-186 ◽  
Author(s):  
Kieran M. Hirpara ◽  
Omar Abouazza ◽  
Barry O'Neill ◽  
Michael O'Sullivan
Keyword(s):  
Tensile Testing ◽  
Flexor Tendon ◽  
Ex Vivo ◽  
Appreciable Amount ◽  
Simple Method ◽  
Flexor Tendons ◽  
Growing Body

There is a growing body of work on the ex vivo tensile testing of tendon repairs, an appreciable amount of which are performed on cadaveric porcine flexor tendons. However, there is little information in the literature on exactly how to perform the dissections necessary to obtain flexor tendons from porcine trotters. We present a simple method to rapidly harvest tendons from the porcine foot, allowing large amounts of material to be harvested in little time for the purpose of tensile testing of tendon repairs.

The Influence of Intratendinous Sodium Hyaluronate on Tendon Healing in Horses

1992 ◽  
Vol 05 (04) ◽  
pp. 151-157 ◽  
Author(s):  
E. M. Gaughan ◽  
R. M. DeBowes ◽  
J. P. Douglass ◽  
R. K. Frank ◽  
R. D. Klemm ◽  
...  
Keyword(s):  
Sodium Chloride ◽  
Ultrasound Guidance ◽  
Flexor Tendon ◽  
Sodium Hyaluronate ◽  
Tendon Healing ◽  
Flexor Tendons ◽  
Significant Difference ◽  
And Control ◽  
Morphometric Evaluation

SummaryAcute tendinitis was created bilaterally in the mid-metacarpal region of the deep digital flexor tendons of six horses with intratendinous collagenase administration. The collagenase-induced lesion in one deep digital flexor tendon of each horse was injected 48 h later with 10.0 mg of sodium hyaluronate (1.0 ml) while employing ultrasound guidance. To serve as a control, the lesion in the contralateral deep digital flexor tendon was injected with 1.0 ml of 0.9% sodium chloride. Sequential ultra-sonographic examinations revealed that the sodium hyaluronate treated deep digital flexor tendons were significantly less enlarged and the collagenase-induced tendon lesions significantly smaller than control tendons and tendon lesions. Difference could not be detected between sodium hyaluronate treated tendons and control tendons using histological and video-interactive planar morphometric evaluation six weeks after treatment.Collagenase-induced tendinitis lesions were treated with intratendinous administration of sodium hyaluronate in six horses. The size of the tendon lesions and the amount of tendon enlargement were significantly less in the sodium hyaluronate treated tendons compared to control tendons. A significant difference in the rate or quality of healing was not detected in the sodium hyaluronate treated tendons.

Does Surgical Glove Powder Increase Adhesions in Flexor Tendon Surgery?

1985 ◽  
Vol 10 (1) ◽  
pp. 65-66 ◽  
Author(s):  
D. JAFFRAY ◽  
A. MA ◽  
C. IRVING
Keyword(s):  
Flexor Tendon ◽  
Adhesion Formation ◽  
Surgical Glove ◽  
Flexor Tendons ◽  
Tendon Surgery

The effects of surgical glove powder on adhesion formation after surgery on the flexor tendons in the chicken was analysed biomechanically. Surgical glove powder did not increase adhesion formation in flexor tendon surgery.

scholarly journals Biomechanical and Dimensional Measurements of the Pulvertaft Weave Versus the Cow-Hitch Technique

Hand ◽  
2016 ◽  
Vol 12 (1) ◽  
pp. 78-84 ◽  
Author(s):  
Nanette L. A. Vincken ◽  
Thomas M. A. S. Lauwers ◽  
Rene R. W. J. van der Hulst
Keyword(s):  
Tensile Strength ◽  
Ultimate Strength ◽  
Tensile Testing ◽  
Statistical Difference ◽  
Adhesion Formation ◽  
Testing Machine ◽  
Digital Analysis ◽  
Tensile Testing Machine ◽  
Dimensional Measurements ◽  
Biomechanical Strength

Background: In this study, biomechanical strength and bulkiness of the cow-hitch technique and Pulvertaft weave were compared. Our goal was to investigate whether the cow hitch can withstand equal strength in comparison with the Pulvertaft and to see if there is a difference in bulk, which could enhance gliding function and reduce friction and adhesion formation. Methods: Sheep tendons were used to perform 10 cow-hitch and 10 Pulvertaft repairs. Tensile strength was obtained with a cyclic loading tensile testing machine and tendon width and height measurements were obtained through digital analysis by photographs of the repairs. Results: The cow hitch showed significantly better ultimate strength and had less bulk. There was no statistical difference in displacement, defined as gain in total length of the tendon. Conclusions: The results in this study show that the cow hitch outperforms the Pulvertaft weave in both ultimate strength and bulk.

Influence of Core Suture Geometry on Tendon Deformation and Gap Formation in Porcine Flexor Tendons

2009 ◽  
Vol 34 (2) ◽  
pp. 190-195 ◽  
Author(s):  
E. T. WALBEEHM ◽  
T. DE WIT ◽  
S. E. R. HOVIUS ◽  
D. A. MCGROUTHER
Keyword(s):  
Flexor Tendon ◽  
Breaking Strength ◽  
Transverse Component ◽  
Gap Formation ◽  
Flexor Tendons ◽  
Pull Out ◽  
Transverse Part ◽  
Transverse Segment ◽  
Tendon Surgery

The effects of core suture geometry on the mechanics of failure in flexor tendon surgery are investigated. Forty porcine flexor tendons were repaired using a Kessler; a Kessler-Pennington; a double Kessler; a continuous Kessler; and a cruciate repair. At maximum breaking strength, the cruciate repair gapped more then the double Kessler (12.8 mm vs 9.1 mm), but the double Kessler was less strong (37N vs 45 N). Transverse narrowing was 22% and 24% for the Kessler and the Kessler-Pennington, 11% for the double Kessler, and 0% for the continuous Kessler and the cruciate repair. Kessler-type sutures failed by suture breakage and the cruciate repair by pull-out. Under load, the transverse part of the Kessler sutures narrows, allowing longitudinal parts to lengthen, leading to gapping. The double Kessler shortened transverse segment decreases gapping. Eliminating a transverse component (the cruciate repair) decreased gapping, but the cruciate failed at higher loads by suture pull-out.

Flexor Tendon Pulley Reconstructions—A Histological and Ultrastructural Study in Non-Human Primates

1989 ◽  
Vol 14 (3) ◽  
pp. 273-277
Author(s):  
JANET DUNLAP ◽  
J. A. McCARTHY ◽  
P. R. MANSKE
Keyword(s):  
Foreign Body ◽  
Foreign Body Reaction ◽  
Flexor Tendon ◽  
Breaking Strength ◽  
Ultrastructural Examination ◽  
Primate Model ◽  
Flexor Tendons ◽  
A2 Pulley ◽  
Host Tissues ◽  
Human Primate

The feasibility of A2 pulley reconstructions using expanded polytetrafluoroethylene (PTFE), woven nylon, and fascia lata was assessed in a non-human primate model and evaluated by light and scanning electron microscopy 18 weeks after implantation. No adhesions were found between reconstructed pulleys and flexor tendons. All types of pulley were intact and incorporated by host tissues, without evidence of a foreign body reaction. The inner surfaces of the fascial and PTFE pulleys, apposed to the gliding flexor tendons, were smooth and covered by a fibrous layer of tissue on microscopic and ultrastructural examination. The apposed visceral synovial surfaces of the F.D.P. tendon were indistinguishable from those from unoperated digits. The FDP tenosynovium apposed to woven nylon pulleys was more fibrillar and granular. Based on the results of the present study and on previous biomechanical data, expanded PTFE should be considered as a material for pulley reconstruction; it is incorporated by host tissues, elicits no foreign body reaction and causes no adhesions or traumatic changes to underlying flexor tendons. It is not yet known whether it has sufficient breaking strength to meet the functional demands of human pulleys.

The Influence of Sequential Intratendinous Sodium Hyaluronate on Tendon Healing in Horses

1995 ◽  
Vol 08 (01) ◽  
pp. 40-45 ◽  
Author(s):  
L. J. Gift ◽  
R. M. De Bowes ◽  
R. Basaraba ◽  
J. Roush ◽  
E. M. Gaughan
Keyword(s):  
Sodium Chloride ◽  
Ultrasound Guidance ◽  
Flexor Tendon ◽  
Sodium Hyaluronate ◽  
Tendon Healing ◽  
Flexor Tendons ◽  
Superficial Digital Flexor Tendon ◽  
Significant Difference ◽  
And Control

SummaryAcute tendinitis was bilaterally created in the mid-metacarpal region of the superficial digital flexor tendons of six horses with intratendinous collagenase administration. The collagenase-induced lesion, in one superficial flexor tendon of each horse, was injected 48 h later with 10.0 mg of sodium hyaluronate (1.0 ml) under ultrasound guidance. In order to serve as a control, the lesion in the contralateral superficial digital flexor tendon was injected with 1.0 ml of phosphate buffered 0.9% sodium chloride. Similar injections were made at weekly intervals for six weeks. Differences could not be detected between sequential sodium hyaluronate treated tendons and control tendons using ultrasonographic, lameness, gross pathological nor histological evaluations.Collagenase-induced superficial digital flexor tendinitis lesions were treated with repeated, sequential intratendinous administration of sodium hyaluronate in six horses. A significant difference in size of the tendon lesions, tendon enlargement, lameness, or tendon healing was not detected between repeated, sequential intratendinous sodium hyaluronate treated and control tendons. The multiple intratendinous injection is not recommended for horses with flexor tendinitis.

An Exploratory Study Using Semi-Tabular Plate in Zone II Flexor Tendon Repair

2018 ◽  
Vol 23 (04) ◽  
pp. 547-553 ◽  
Author(s):  
Yoke-Rung Wong ◽  
Ita Suzana Mat Jais ◽  
Min-Kai Chang ◽  
Beng-Hai Lim ◽  
Shian-Chao Tay
Keyword(s):  
Tensile Strength ◽  
Ultimate Tensile Strength ◽  
Coefficient Of Friction ◽  
Flexor Tendon ◽  
Tendon Repair ◽  
Flexor Digitorum Profundus ◽  
Flexor Tendon Repair ◽  
Flexor Tendons ◽  
Custom Made ◽  
Zone Ii

Background: This study evaluated the feasibility of using a low-profile titanium (Ti) plate implant, also known as the Ti-button, for Zone II flexor tendon repair. We hypothesize that the use of the Ti-button can distribute the tensile force on the digital flexor tendons to achieve better biomechanical performance. Methods: Twenty lacerated porcine flexor tendons were randomly divided into two groups and repaired using Ti-button or 6-strand modified Lim-Tsai technique. Ultimate tensile strength, load to 2 mm gap force, and mode of failure were recorded during a single cycle loading test. We also harvested twelve fingers with lacerated flexor digitorum profundus tendons from six fresh-frozen cadaver hands and repaired the tendons using either Ti-button method or modified Lim-Tsai technique. A custom-made bio-friction measurement jig was used to measure the gliding resistance and coefficient of friction of the tendon sheath interface at the A2 pulley. Results: The ultimate tensile strength, load to 2 mm gap force, stiffness, and gliding resistance of the Ti-button repairs were 101.5 N, 25.7 N, 7.8 N/mm, and 2.2 N respectively. Ti-button repairs had significantly higher ultimate tensile strength and stiffness than the modified Lim-Tsai repair. However, Ti-button also increased the gliding resistance and coefficient of friction but there was no significant difference between the two repair techniques. Conclusions: Ti-button repair displayed comparable mechanical properties to the traditional repair in terms of 2-mm gap formation and gliding resistance, but with a stronger repair construct. Thus, this deepened our interest to further investigate the potential of using Ti-button implant in Zone II flexor tendon repair by studying both the mechanical and biochemical (tendon healing) properties in more in-depth.

scholarly journals A Biomechanical Study of a Novel Asymmetric 6-Strand Flexor Tendon Repair Using Porcine Tendons

Hand ◽  
2017 ◽  
Vol 13 (1) ◽  
pp. 50-55
Author(s):  
Yoke Rung Wong ◽  
Shian Chao Tay
Keyword(s):  
Tensile Strength ◽  
Ultimate Tensile Strength ◽  
Flexor Tendon ◽  
Tendon Repair ◽  
Biomechanical Study ◽  
Flexor Tendon Repair ◽  
Flexor Tendons ◽  
Repair Technique ◽  
Mechanism Of Failure

Background: This study evaluated the biomechanical performance of a novel asymmetric 6-strand flexor tendon repair technique without locking loops. Methods: Twenty porcine flexor tendons were equally repaired by using the asymmetric technique and compared with the modified Lim-Tsai repair technique. The ultimate tensile strength, load to 1-mm gap force, stiffness, and mechanism of failure were measured. Results: The asymmetric repair technique had significantly higher tensile strength (63.3 ± 3.7 N) than the modified Lim-Tsai repairs (46.7 ± 8.3 N). Conclusions: A novel flexor tendon repair technique with improved biomechanical performance may be available for use in flexor tendon repairs.

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