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Vascularised flexor tendon grafts

W A Morrison1, H Cleland

  • 1Department of Surgery, St Vincent's Hospital, Fitzroy Vic, Australia.

Annals of the Academy of Medicine, Singapore
|July 1, 1995
PubMed
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Vascularized tendon grafts offer a solution for digit reconstruction in scarred hands. These grafts, transferred with their own blood supply, improve tendon gliding and function.

Area of Science:

  • Hand surgery
  • Orthopedic surgery
  • Regenerative medicine

Background:

  • Tendon reconstruction in scarred digits is challenging due to poor blood supply, leading to adhesions and gliding failure.
  • Previous methods like staged grafting with silicone spaces do not address the core issue of vascularity.

Purpose of the Study:

  • To evaluate the efficacy of vascularized tendon grafts for digital reconstruction.
  • To explore the use of free or pedicled vascularized tendon transfers to improve tendon gliding in scarred digits.

Main Methods:

  • Utilized vascularized tendon grafts with intact fascial or synovial sheaths.
  • Transferred tendons from the foot (extensor hallucis brevis/longus, extensor digitorum communis) or forearm (palmaris longus, sublimus tendons, extensor indicis).

Related Experiment Videos

  • Implanted grafts into intact or reconstructed digital tunnel systems, with proximal and distal repairs.

    • Main Results:

    • Vascularized tendon grafts demonstrated enhanced gliding within the digital tunnels.
    • Potential limitations were noted at the proximal tendon junctions.

    Conclusions:

    • Vascularized tendon grafts, transferred with their native vascular supply, represent a promising approach for digital tendon reconstruction.
    • This technique overcomes the limitations of avascular grafts in scarred environments, improving functional outcomes.