+ Site Statistics
+ Search Articles
+ Subscribe to Site Feeds
EurekaMag Most Shared ContentMost Shared
EurekaMag PDF Full Text ContentPDF Full Text
+ PDF Full Text
Request PDF Full TextRequest PDF Full Text
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter
Follow on Google+Follow on Google+
Follow on LinkedInFollow on LinkedIn

+ Translate

Effect of flexor sheath integrity on tendon gliding: a biomechanical and histologic study

Journal of Orthopaedic Research 4(4): 458-465
Effect of flexor sheath integrity on tendon gliding: a biomechanical and histologic study
The effect on tendon gliding of flexor sheath excision versus incision/closure following primary flexor tendon repair was examined biomechanically and histologically in forty-one chickens. There was no significant difference in either the tendon excursion required to fully flex the digit or in the work of flexion (the integration of the forces that resist tendon gliding during excursion) between the sheath excised and sheath closed groups. The results were unaffected by postoperative immobilization or intermittent passive motion. Histologically, it was noted that at 3 weeks the healing tendon was surrounded by a layer of granulation tissue that was nearly identical in both the sheath excised and the sheath closed digits. Of note was the finding that a synovial lining could not be identified in those digits that had previously undergone sheath closure. However, at 6 weeks postoperatively, a new gliding surface could be identified surrounding the tendon in both the sheath excised and the sheath closed digits. This study indicates that closure of the flexor sheath after primary tendon repair does not improve tendon gliding as measured biomechanically. Despite its repair, the flexor sheath does not maintain its synovial characteristics as demonstrated histologically, and a new sheath must subsequently be formed.

Accession: 005239395

PMID: 3783301

DOI: 10.1002/jor.1100040409

Download PDF Full Text: Effect of flexor sheath integrity on tendon gliding: a biomechanical and histologic study

Related references

Experimental reconstruction of flexor tendon injury by substitution of the tendon sheath using a vein, and 2-stage flexor tendon surgery a new surgical procedure for the reconstruction of the peritendinous gliding surfaces. Magyar Traumatologia, Orthopaedia Es Helyreallito Sebeszet 18(2): 143-151, 1975

Flexor tendon-tendon sheath interaction after tendon grafting: a biomechanical study in a human model in vitro. Journal of Hand Surgery 24(5): 1097-1102, 1999

Primary tendon sheath enlargement and reconstruction in zone 2: an in vitro biomechanical study on tendon gliding resistance. Journal of Hand Surgery 34(8): 1436-1443, 2009

Gliding resistance of flexor tendon associated with carpal tunnel pressure: a biomechanical cadaver study. Journal of Orthopaedic Research 29(1): 58-61, 2011

Effect of triggering and entrapment on tendon gliding properties following digital flexor tendon laceration: in vitro study on turkey tendon. Journal of Hand Surgery, European Volume 39(7): 708-713, 2015

Gliding function following flexor-tendon injury. A biomechanical study of rat tendon function. Journal of Bone and Joint Surgery. American Volume 58(7): 985-990, 1976

Experimental single-stage reconstruction of the tendon sheath and flexor tendon (free tendon graft, using a vein for sheath on the flexor tendon in dogs). Magyar Traumatologia, Orthopaedia Es Helyreallito Sebeszet 19(1): 52-59, 1976

Gliding resistance and strength of composite sutures in human flexor digitorum profundus tendon repair: an in vitro biomechanical study. Journal of Hand Surgery 34(1): 87-92, 2009

Effect of various methods of restoring flexor sheath integrity on the formation of adhesions after tendon injury. Journal of Hand Surgery 15A(1): 48-56, 1990

A2 pulley integrity and the strength of flexor tendon repair: a biomechanical study in a chicken model. Hand Surgery 20(1): 11-17, 2015