- Publikační typ
- abstrakt z konference MeSH
- MeSH
- autologní transplantace MeSH
- lidé MeSH
- odběr tkání a orgánů * metody MeSH
- pilotní projekty MeSH
- separace buněk metody MeSH
- tuková tkáň * transplantace MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- abstrakt z konference MeSH
PURPOSE OF THE STUDY Two tendons, i.e., the extensor indicis proprius (EIP) and the extensor carpi radialis longus (ECRL), are commonly used to reconstruct the function of a ruptured extensor pollicis longus (EPL) tendon. We reviewed a group of patients with EPL ruptures treated by ECRL tendon transfer to the EPL tendon, which was the method of choice. The aim was to evaluate the results and to assess the effect of ECRL detachment on hand function. MATERIAL AND METHODS Twenty patients were treated surgically for a subcutaneous rupture of the EPL tendon between 2003 and 2007. Each patient was examined at 2 years after surgery. The range of motion (ROM) of both the injured and the contralateral hand was recorded and evaluated with a modified Geldmacher scoring system; a response to the DASH questionnaire was obtained. The mean follow-up was 24 months (19-31 months). RESULTS For the ROM of the operated hand, the mean Total Active Motion (TAM) of 98.75 degrees (60-140, SD 22.74) was calculated. The mean extension lag at the interphalangeal (IP) joint was 5.42 degrees (0-25, SD 8.77) and the mean IP flexion was 65.8 degrees (40-80, SD 13.2). In order to evaluate body side differences, the ROM of the contralateral thumb was recorded. The values were as follows: mean TAM, 141.3 degrees (115-190, SD 20.43); mean IP extension lag, 0 degrees (0-0, SD 0); mean IP flexion, 68.8 degrees (50-80, SD 9.6). DISCUSSION The extension lag at the IP joint was detected in both the operated and the contralateral hands. The patients examined at a longer interval after surgery showed an increase in extension lag. This may have been caused by undesired adaptation of the donor muscle, the presence of adhesions or suture loosening. CONCLUSIONS The results showed increased adaptation of thumb motion to the extension lag at the IP joint, which had a mild effect on the patient's hand function. The difference in wrist extension between the operated and the contralateral hand corresponded to the pre-operative condition.
- MeSH
- dospělí MeSH
- hodnocení výsledků zdravotní péče statistika a číselné údaje MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- obnova funkce MeSH
- ortopedické výkony využití MeSH
- palec ruky fyziologie chirurgie zranění MeSH
- poranění šlachy chirurgie MeSH
- přenos šlachy metody statistika a číselné údaje využití MeSH
- průzkumy a dotazníky MeSH
- rozsah kloubních pohybů MeSH
- senioři MeSH
- spontánní ruptura chirurgie MeSH
- svalová síla MeSH
- výsledek terapie MeSH
- zákroky plastické chirurgie metody využití MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
BACKGROUND: The finger range of motion (ROM) was evaluated in patients with hand flexor tendon replacement using a tendon graft and the effect of smoking was investigated. The first hypothesis was: a tendon graft increases the post-operative ROM. The second hypothesis was: smoking has a negative effect on the final finger ROM. PATIENTS AND METHODS: Fifty seven autologous tendon grafts in 48 patients were included. The patients were grouped as non-smokers or smokers ("light" or "heavy"). The modified Strickland system and Total Active Motion (TAM) system, were chosen for the evaluation. RESULTS: The first hypothesis was proved by all the measurements. The post-operative status assessed by the Strickland method was different between the non-smokers and smokers with a better score in the smokers. CONCLUSION: A significant ROM improvement occurs after reconstruction and is even slightly better in smokers than in non-smokers.
Cíl: Cílem naší práce bylo srovnání pevnosti 2- a 4vláknové korové šlachové sutury v experimentálním modelu při použití 3 typů šicích vláken. Materiál a metodika: Vytvořili jsme model z tvrzeného teflonu s nulovou elasticitou, který manifestoval pouze vlastnosti šicího materiálu a použité sutury. Použili jsme 3 typy šicích materiálů: monofilní nevstřebatelný polypropylen (Chiralen), monofilní vstřebatelný polymer (Polydox) a pletený nevstřebatelný polyester (Tervalon) o síle USP 3/0. Jako 2vláknovou suturu jsme zvolili Kesslerův steh, jako 4vláknovou pak suturu dle McLarneyové. Test byl proveden na trhacím přístroji ZWICK. Výsledky: Při použití vlákna Chiralen a sutury dle Kesslera je průměrný Fmax 31,86 N a gapping eFmax 6,97 mm, dle McLarneyové pak 63,42 N a 4,21 mm. Při použití vlákna Polydox a sutury dle Kesslera Fmax 46,86 N a eFmax 14,4 mm, dle McLarneyové pak 74,15 N a 4,82 mm. Vlákno Tervalon se suturou dle Kesslera Fmax 42,36 N a eFmax 6,83 mm, sutura dle McLarneyové 73,78 N a 3,1 mm. Závěr: Nejbezpečnějším vláknem pro šlachovou suturu s nejlepší kombinací pevnosti a elasticity je v našem experimentálním modelu nevstřebatelné pletené vlákno typu Tervalon.
Introduction: The goal of our article was to evaluate tensile strength of 2-strand and 4-strand tendon core suture in an experimental model while using 3 different suture materials. Material and Methods: We designed a model made of toughed Teflon with zero elasticity which shows only characteristics of suture material and used suture type. We used 3 types of suture material: monofilament nonabsorbable polypropylene (Chiralen), monofilament absorbable polymer (Polydox) and braided nonabsorbable polyester (Tervalon) USP 3/0. Kessler suture represented 2-strand sutures and McLarney technique stood for 4-strand core sutures. All tests were done with Zwick testing machine. Results: Using Chiralen and Kessler suture we gained mean Fmax 31.86 N and gapping eFmax 6.97 mm, McLarney suture 63.42 N and 4.21 mm. Using Polydox and Kessler suture Fmax 46.86 N and eFmax 14.4 mm, McLarney 74.15 N and 4.82 mm. Using Tervalon and Kessler suture Fmax 42.36 N and eFmax 6.83 mm, McLarney 73.78 N and 3.1 mm. Conclusion: In our experiment, the safest material for tendon suture with the best combination of tensile strength and elasticity was braided nonabsorbable polyester (Tervalon).
- Klíčová slova
- vlastnosti stehu, sutura flexoru,
- MeSH
- biologické modely MeSH
- poranění šlachy chirurgie MeSH
- ruptura chirurgie MeSH
- šicí techniky normy využití MeSH
- sutura normy využití MeSH
