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Flexor Tendon Repairs PowerPoint Presentation

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Description : Check out this medical PowerPoint presentation titled "Flexor tendon repairs” by Tony Barabás.

This medical PowerPoint presentation is about flexor tendon repairs, surgical procedures that involve repairing or reattaching tendons in the hand or fingers that have been damaged or severed. These tendons are responsible for flexing the fingers and hand.

The procedure typically involves making a small incision in the hand or finger and using sutures to reattach the torn ends of the tendon. In some cases, a graft may be used to reinforce the repair.

After the surgery, the hand or finger will be immobilized in a splint or cast for several weeks to allow the tendon to heal. Physical therapy is typically necessary to restore the hands strength and range of motion.

It is important to note that recovery from flexor tendon repair can be a long and challenging process, and success depends on a variety of factors, including the severity of the injury and the patients commitment to rehabilitation.

Tags : Flexor tendon repairs, Orthopaedic Surgery, Orthopaedic Surgery PowerPoint presentation

Published on : Jun 20, 2023 | Views : 1540 | Downloads : 1

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Slide 1-

Flexor tendon repairsTony BarabásColville Team teachingSt George’s Hospital
Slide 2-

Principles of tendon repair Number and size of incisions in sheath kept to minimum A2 and A4 preserved if possible Make incisions in sheath between annular pulleys Minimal touching of tendon ends Reconstruct the sheath if possible but don’t compromise glide
Slide 3-

Principles of tendon repair Epitendinous suture of back-wall first to correctly align tendon, inverting, continuous Core suture → Bunnell, Kessler, Modified Kessler (self-locking), Strickland 2, 4 or 6 strand repair.
Slide 4-

Characteristics of ideal repairStrickland Sutures easily placed in tendon Secure suture knots Smooth juncture of tendon ends Minimal gapping at the repair site Minimal interference with tendon vascularity Sufficient strength throughout healing to permit early motion stress on tendon
Slide 5-

Core Sutures
Slide 6-

With increasing strands ↑ technical difficulty ↑ damage to tendon ends Compromises nutrition and ability to heal
Slide 7-

Modified Kessler
Slide 8-

Grip Strength by strand #’s over weeks since repair 0 1 3 6 0 4000 2000 6000 8000 Force in grams Time in weeks 2 strand 4 strand 6 strand . . . . . . . . . Passive . . . . . . . Strong grip . . . . Light active . . . .
Slide 9-

Suture materials Size 3.0 or 4.0 Monofilament passes thru tendon more easily, however knots slip more easily Braided/polyfilament hold knots better, but ? more trauma to tendon on insertion
Slide 10-

Epitendinous sutures Why use them?
Slide 11-

1. To stop gapping! Gapping → considerable weakening of repair Unfavourably alters tendon mechanics ↑’s adhesion formation → ↓ tendon excursion Silfverskoild et al, Pruitt et al, Lin et al Poorer clinical outcomes after gapping Seradge
Slide 12-

2. Increase repair strength 10 – 50% ↑ in repair strength Silfverskoild et al, Dial et al, Wade et al
Slide 13-

3. To smooth edges Doesn’t catch on pulleys Glides more smoothly
Slide 14-

Simple running
Slide 15-

Silfverskiold
Slide 16-

Sheath repair advantages = barrier to extrinsic adhesions Quicker return to synovial nutrition Acts as a mold for the remodelling tendon Results in better tendon-sheath biomechanics
Slide 17-

Sheath repair disadvantages Technically difficult May narrow and restrict tendon gliding