Tenolysis and Salvage Procedures - 18/04/23

Doi : 10.1016/j.hcl.2022.08.021

David Cholok, MD ^a,^⁎ , Jordan Burgess, BA ^a, Paige M. Fox, MD, PhD ^a,^b, James Chang, MD ^a,^b
^a Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, 770 Welch Road, Suite 400, Palo Alto, CA 94304, USA
^b Division of Plastic and Reconstructive Surgery, Chase Hand and Upper Limb Center, Stanford University Medical Center, 770 Welch Road, Suite 400, Palo Alto, CA 94304, USA

^∗Corresponding author.

Resumen

Complications in flexor tendon repair are common and include tendon rupture, adhesion formation, and joint contracture. Risk factors include preexisting conditions, gross contamination, concurrent fracture, early unplanned loading of the repaired tendon, premature cessation of splinting, and aggressive early active range of motion protocols with insufficient repair strength. Rupture of a repaired tendon should be followed by early operative exploration, debridement, and revision with a four-core strand suture and nonbraided epitendinous suture. Wide-awake flexor tenolysis should be considered when adhesion formation results in the plateaued range of motion, and passive motion exceeds active motion. Two-staged reconstruction is recommended when injury results in excessive scaring, joint contracture, or an incompetent pulley apparatus.

El texto completo de este artículo está disponible en PDF.

Keywords : Two-staged flexor tendon reconstruction, Flexor tenolysis, Tendon rupture, Adhesion formation, Joint contracture