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Muscles of the Forearm that Move the Hand and Fingers01:16

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The muscles of the forearm that move the wrist, hand, and digits are numerous and diverse. They can be classified into two groups based on their location and function — the anterior and posterior compartment muscles.
Anterior Compartment
The anterior compartment muscles originate from the humerus. They primarily function as flexors and are also known as flexor muscles. They typically insert on the carpals, metacarpals, and phalanges. The superficial layer includes the flexor carpi radialis,...

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Polytetrafluoroethylene (PTFE) as a Suture Material in Tendon Surgery
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An inverting circumferential suture for flexor tenorraphy.

P J Sullivan1, K M Hirpara, C E Healy

  • 1Department of Plastic Surgery, National University of Ireland, Galway, Ireland. sullivanpaul@yahoo.com

Hand Surgery : an International Journal Devoted to Hand and Upper Limb Surgery and Related Research : Journal of the Asia-Pacific Federation of Societies for Surgery of the Hand
|May 7, 2011
PubMed
Summary
This summary is machine-generated.

A new inverting epitendinous technique for flexor tendon repair shows promise. This method improves tendon gliding and strength, potentially leading to better patient outcomes in challenging zone two repairs.

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Regenerative Medicine

Background:

  • Zone two flexor tendon repair presents significant challenges, often leading to poor patient outcomes due to tendon adhesions.
  • Current surgical techniques aim to balance repair strength with minimizing bulk to prevent adhesion formation and allow movement.

Purpose of the Study:

  • To evaluate a novel inverting epitendinous technique for flexor tendon repair.
  • To compare its biomechanical properties against established methods like the modified Kessler and Adelaide repairs.

Main Methods:

  • Sixty porcine tendons were randomized into two core repair groups (2-stranded modified Kessler vs. 4-stranded Adelaide).
  • Each group was further subdivided into three circumferential epitendinous techniques: locked running, Silfverskiold, and a new inverting repair.
  • Digital tensiometry was used to analyze load to failure (LTF), 2 mm gap formation, and bulking effect.

Main Results:

  • Four-stranded repairs exhibited superior load to failure (LTF) compared to two-stranded techniques.
  • The inverting epitendinous and Silfverskiold repairs demonstrated higher LTF and better tissue holding capacity than the locked running suture.
  • The novel inverting repair created a smooth, inverted construct with biomechanical properties comparable to existing methods.

Conclusions:

  • The novel inverting epitendinous technique offers potential gliding benefits and improved outcomes for zone two flexor tendon repair.
  • This technique provides comparable strength and tissue holding to established methods while potentially reducing adhesion formation.
  • Further clinical studies are warranted to confirm the benefits of this inverting repair in human patients.