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.

BILATERAL THUMB METACARPOPHALANGEAL JOINT FUSIONS FOR SEVERE HYPEREXTENSION DEFORMITIES IN CONJUNCTION WITH CARPOMETACARPAL JOINT RECONSTRUCTIONS

Hand Surgery ◽  
2013 ◽  
Vol 18 (02) ◽  
pp. 257-260 ◽  
Author(s):  
Cynthia Tsang ◽  
Alistair R. Hunter ◽  
Elliot D. Sorene
Keyword(s):  
Functional Results ◽  
Mechanical Efficiency ◽  
Metacarpophalangeal Joint ◽  
Contralateral Side ◽  
Functional Improvement ◽  
Dash Score ◽  
Joint Reconstruction ◽  
Initial Surgery ◽  
K Wires ◽  
Cmc Joint

Background: Hyperextension of the first metacarpophalangeal (MCP) joint and adduction of the first web space of the hand are features of advanced stages of carpometacarpal (CMC) joint arthrosis. Restoration of mechanical efficiency in such patients requires stabilization of both the CMC and MCP joints. This study describes a patient with bilateral secondary hyperextension of the MCP joint greater than 50° who displayed good functional outcome following staged bilateral MCP joint arthrodesis with simultaneous CMC joint reconstruction. Case Report: Excision of trapezium, formation of a Weilby sling utilising flexor carpi radialis, and insertion of a Swanson's prosthesis forms the basis of CMC joint reconstruction. Fusion of the MCP joint involved placement of longitudinal K-wires and tension band wiring. The patient underwent an initial right-sided procedure in 2008 and subsequently elected for the same procedure on the contralateral side 26 months later. Good functional improvement was achieved with a pre and postoperative DASH score of 49 and 8 respectively. Follow-up and radiological imaging at 34 months from her initial surgery confirmed good positions of the prostheses and solid MCP joint fusions. The patient developed postoperative interphalangeal joint pain, which responded to steroid injection. Discussion: There is currently limited evidence available addressing the management of severe hyperextension deformity greater than 50° of the MCP joint in the presence of CMC joint arthrosis. Staged bilateral fusion of the MCP joint and simultaneous CMC joint reconstruction in this case illustrates good, reproducible functional results and patient satisfaction with reduced postoperative return to function.

Spontaneous Rupture of the Flex or Pollicis Longus Tendon on a Sesamoid Bone

1997 ◽  
Vol 22 (3) ◽  
pp. 381-382 ◽  
Author(s):  
J. B. WEBB ◽  
D. ELLIOT
Keyword(s):  
Spontaneous Rupture ◽  
Metacarpophalangeal Joint ◽  
Sesamoid Bone ◽  
Flexor Pollicis Longus ◽  
Longus Tendon ◽  
Flexor Pollicis Longus Tendon

We report a case of rupture of the flexor pollicis longus tendon due to attrition by the ulnar sesamoid bone of the metacarpophalangeal joint of the thumb secondary to osteoarthritic changes of this bone.

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.

Correction of Wassel type IV thumb duplication with zigzag deformity: results of a new method of flexor pollicis longus tendon relocation

2012 ◽  
Vol 38 (3) ◽  
pp. 272-280 ◽  
Author(s):  
C. H. Lee ◽  
H. Y. Park ◽  
J. O. Yoon ◽  
K. W. Lee
Keyword(s):  
Treatment Algorithm ◽  
Suture Technique ◽  
Flexor Pollicis Longus ◽  
Longus Tendon ◽  
Type Iv ◽  
Pull Out ◽  
Thumb Duplication ◽  
Flexor Pollicis Longus Tendon ◽  
Pull Out Suture

The purpose of this study is to present a treatment algorithm and a method of flexor pollicis longus tendon relocation for Wassel type IV thumb duplication with zigzag deformity. Forty-two thumbs in 42 patients were included in this study and the mean follow-up was 4 years. In addition to excision of the extra digit, tendon relocation and metacarpal and/or proximal phalangeal osteotomy were carried out, based on the degree of angulation at the metacarpophalangeal and interphalangeal joints. Tendon relocation was achieved using our pull-out suture technique. The results were assessed using an evaluation form for thumb polydactyly provided by the Japanese Society for Surgery of the Hand. At the time of latest clinical contact, eight cases were rated good, 31 cases fair, and three cases poor. It is useful to decide surgical procedures according to the degree of angulation of the metacarpophalangeal and interphalangeal joints and flexor pollicis longus tendon relocation is important to prevent malalignment at the interphalangeal joint.

scholarly journals Six-Strand Flexor Pollicis Longus Tendon Repairs With and Without Circumferential Sutures: A Multicenter Study

Hand ◽  
2022 ◽  
pp. 155894472110572
Author(s):  
Géraldine Lautenbach ◽  
Marco Guidi ◽  
Bernadette Tobler-Ammann ◽  
Vera Beckmann-Fries ◽  
Elisabeth Oberfeld ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Tendon Repair ◽  
Suture Technique ◽  
Flexor Pollicis Longus ◽  
Postoperative Rehabilitation ◽  
Active Motion ◽  
Treatment Groups ◽  
Longus Tendon ◽  
Outcome Measurements ◽  
Flexor Pollicis Longus Tendon

Background: The purpose of this study is to assess outcomes in flexor pollicis longus tendon repairs with 6-strand core sutures with and without circumferential sutures. Methods: A 6-strand core suture technique with and without circumferential sutures was used. Thirty-three patients were summarized in the C group (circumferential group) and 16 patients in the NC group (non-circumferential group). After the surgery, the wrist was stabilized with a dorsal blocking splint and a controlled early active motion protocol was applied. At weeks 6, 13, and 26 data on demographics, type of injury, surgery, postoperative rehabilitation, complications such as re-rupture and the following outcome measurements were collected: range of motion and its recovery according to the Tang criteria, Kapandji score, thumb and hand strengths, Disabilities of the Arm, Shoulder and Hand score, and satisfaction. Results: There were no significant differences in range of motion and strength between the 2 treatment groups. In both groups, the outcome measurements increased over time and they expressed similar satisfaction with the surgical treatment. In 4 patients of the C group tendon repair ruptured and in 1 patient of the NC group. Conclusions: Six-strand repair technique is an effective procedure to assure early active motion after flexor pollicis longus tendon injuries and good results can also be achieved by omitting the circumferential suture.

A volar approach to on-top plasty for correction of radial polydactyly: a case series of 21 patients

2021 ◽  
pp. 175319342098185
Author(s):  
Xia Fang ◽  
Ping-tak Chan ◽  
Shengbo Zhou ◽  
Xinyi Dai ◽  
Ruiji Guo ◽  
...  
Keyword(s):  
Case Series ◽  
Functional Results ◽  
Metacarpophalangeal Joint ◽  
Contralateral Side ◽  
Average Score ◽  
Pinch Strength ◽  
Level Of Evidence ◽  
Volar Approach ◽  
Flexion Extension ◽  
Aesthetic Results

Correction of unequal radial polydactyly in which neither thumb duplicates possess both well-developed proximal and distal components, remains challenging. Current techniques using on-top plasty techniques require circumferential incisions, often resulting in postoperative swelling and dorsal scars. We described our experience using a volar approach to achieve better aesthetic and functional results. Twenty-one patients underwent this surgery between 2008 and 2018, with a mean follow-up of 5.1 years. The mean flexion–extension arc for the metacarpophalangeal joint was 75° and that of the interphalangeal joint was 43°. Mean percentage of key, tripod and tip pinch strength were 77%, 79% and 77%, respectively, when compared with the contralateral side. The Vancouver Scar Scale showed an average score of 1.2. We conclude from our study that the volar approach to on-top plasty is a good technique for the correction of unequal radial polydactyly, with good functional and aesthetic results. Level of evidence: IV

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