Flexor Tendon Injuries

Table of contents :
Flexor tendon injuries……Page 6
History of Flexor Tendon Repair……Page 8
References……Page 11
Tendon anatomy……Page 13
Time-dependent factors……Page 14
Dynamics of flexor tendons……Page 16
Biomechanics of the flexor pulley system……Page 17
Digital fibro-osseous canal……Page 18
Flexor digitorum profundus……Page 20
Flexor digitorum superficialis……Page 22
Models of flexor tendon function……Page 23
Biomechanics of flexor tendon repairs……Page 25
Tendon forces……Page 26
References……Page 27
Flexor tendons: anatomy and surgical approaches……Page 34
Surgical approaches……Page 35
Summary……Page 39
References……Page 40
Tendon structure and nutrition……Page 41
Biomechanics……Page 42
Repair site biochemistry……Page 43
References……Page 44
Zone I flexor tendon injuries……Page 49
References……Page 52
Clinical history and physical examination……Page 54
Indications for surgery……Page 55
Surgical technique……Page 57
Pitfalls……Page 59
References……Page 60
Anatomy……Page 61
Diagnosis……Page 62
Postoperative considerations……Page 64
Outcomes……Page 65
References……Page 66
Tendon healing……Page 67
Tendon……Page 68
Vascular……Page 69
Nerves……Page 71
Skin……Page 72
Replantation, revascularization, and amputation……Page 74
Summary……Page 75
References……Page 76
Outcomes of flexor tendon repair: an overview of experience over the past 15 years……Page 78
Adhesion formation……Page 80
Repair rupture……Page 81
Surgical skills……Page 82
Evaluation of outcome and possible modifications……Page 83
Stronger surgical repairs……Page 84
Sheath/pulley management……Page 85
Optimization of rehabilitation regimen……Page 86
References……Page 87
Indication and timing……Page 90
Technique……Page 91
Indwelling catheter……Page 93
Results……Page 94
References……Page 95
Division of the flexor digitorum profundus and superficialis……Page 97
Indications……Page 98
Surgical technique……Page 99
Surgical technique……Page 103
Flexor tendon grafting summary……Page 104
Anesthesia and tourniquet……Page 105
Surgical technique……Page 106
Postoperative considerations……Page 111
Flexor tenolysis summary……Page 112
Indications……Page 113
Surgery technique: stage one……Page 114
Surgery technique: stage two……Page 116
Summary……Page 117
References……Page 118
Function of the pulleys……Page 122
Reconstructive options……Page 123
Triple loop technique……Page 124
Lister’s technique……Page 125
Complications……Page 126
References……Page 127
Diagnosis……Page 129
Rehabilitation……Page 130
Repair results……Page 131
References……Page 132
Immobilization program……Page 133
Kleinert program……Page 134
Early active motion……Page 135
Stage I……Page 138
Rehabilitation after tenolysis……Page 139
References……Page 140
The future of flexor tendon surgery……Page 142
Cell-based strategies……Page 143
Molecular medicine……Page 144
Gene therapy……Page 145
References……Page 146