PubMed HealthSearch

PubMed · 7876501

Tendon repair using flexor tendon splints: an experimental study.

Abstract

Mechanical strength of tendon repair using Dacron tendon splints across the laceration site were evaluated in human cadaver profundus tendons; the splints were placed both on the dorsal surface and internally within the tendon substance. Comparison was made to modified Kessler, Becker, and Savage repair techniques. Ultimate tensile strength was 2.55 kgf for the Kessler, 3.00 kgf for the Becker, 8.29 kgf for the Savage, 8.46 kgf for the internal tendon splint, and 8.10 kgf for the dorsal tendon splint; the Savage and both Tendon Splints techniques had significant higher tensile strength than the Kessler and Becker. Gap strength was 1.44 kgf for the Kessler, 2.22 kgf for the Becker, 2.45 kgf for the Savage, 2.05 kgf for internal tendon splint, and 3.15 kgf for the dorsal tendon splint. The dorsal tendon splint technique showed significant greater gap strength than the other four techniques. There was no significant difference in the magnitude of the gap during cyclic testing of these techniques; however, three of seven Kessler repairs failed and one of six Becker repairs failed. The results of these cadaver studies suggest that both tendon splint repair techniques are comparable to the Savage and may have sufficient strength to allow postoperative active motion against minimal resistance. Further in vivo testing is in order.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

M Aoki, P R Manske, D L Pruitt, B J Larson. 1994. Tendon repair using flexor tendon splints: an experimental study.. https://doi.org/10.1016/0363-5023(94)90102-3

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

The "floppy" Nissen fundoplication is a completely competent antireflux valve.

BACKGROUND: The antireflux capacity of various gastric fundoplications combines the creation of a valve (flapper or nipple) with recreation of a sharp cardioesophageal angle. Experimental comparison of valve competency and appropriate valve geometry is incomplete despite wide application of these techniques. Our primary aim was to compare the competency of several antireflux valves in explanted cadaver stomachs. Our secondary aim was to understand better the geometry of the gastric fundus in empty and full stomachs. METHODS: Stomachs with 6-8 cm of distal esophagus were harvested from 18 fresh cadavers. With the stomach empty, the greater and lesser curvature length and the transverse dimensions of the anterior and posterior surface of the stomach in the fundus, body, and antrum were measured. The pylorus was tied off over a catheter; the stomachs were inflated with water; and reflux occurred. Intragastric pressure was measured during inflation with a needle inserted in the side of the stomach. A clamp was then placed on the esophagus, and the stomach was inflated to a pressure of 10 mmHg. Gastric measurements were recalculated in the distended stomach. The stomachs were deflated, the clamp removed, and a 2-cm Nissen fundoplication as well as 270 degrees and 180 degrees posterior fundoplications were performed over a 60 Fr dilator. The stomachs were reinflated while the pressure was transduced. The inflation was stopped when reflux occurred or when the fundoplication disrupted. RESULTS: The stomachs expanded symmetrically when filled with water except for the fundus in which the anterior gastric wall lengthened by more than 100% and the posterior gastric wall lengthened by about 50%. In the untreated stomachs, reflux occurred at a pressure of 3.0 +/- 1.0 mmHg. After fundoplication, reflux never occurred, but the sutures pulled out of the stomach or esophagus at 28.6 +/- 16.8 mmHg. Posterior fundoplications refluxed water in several stomachs. CONCLUSIONS: When filled, the anterior fundus expands to a greater degree than the posterior fundus, offering more tissue for creation of floppy fundoplication. The "floppy" Nissen fundoplication is completely competent, suffering a degradation before allowing reflux. The posterior partial fundoplication is unpredictable in its competency.

Cadaver

Anatomic study of the lateral femoral cutaneous nerve with respect to the ilioinguinal surgical dissection.

OBJECTIVE: To report on the anatomic variations of the lateral femoral cutaneous nerve with respect to the ilioinguinal surgical dissection. DESIGN: Cadaveric anatomic study. PATIENTS/PARTICIPANTS: Sixty-eight ilioinguinal dissections performed in fifty cadavers. INTERVENTION: The lateral femoral cutaneous nerve was identified, and certain location variables were recorded. MAIN OUTCOME MEASURE: The distance in millimeters from the medial edge of the anterior superior iliac spine (ASIS), whether the nerve was lateral or medial to the ASIS, and the layer in which the nerve crossed the dissection. RESULTS: In seven dissections, the nerve was twenty-one to twenty-five millimeters medial to the ASIS; in ten dissections, the nerve was twenty-six to thirty millimeters from the ASIS; and in fourteen dissections, the nerve was more than thirty millimeters medial to the superior border of the ASIS. The average medial distance from the ASIS was 20.4 millimeters, with a range of three to forty-six millimeters. In no specimen did the nerve pass lateral to the ASIS. The lateral femoral cutaneous nerve was found to lie anterior to the iliopsoas muscle in all specimens. CONCLUSION: The course of the lateral femoral cutaneous nerve is highly variable; the nerve was most commonly found at ten to fifteen millimeters from the ASIS and as far medially as forty-six millimeters. When using the illioinguinal surgical approach, if the lateral femoral cutaneous nerve is not encountered immediately adjacent to the ASIS, dissection up to five centimeters medial to the ASIS may be necessary to locate the nerve.

Cadaver

Endoscopic technique for harvesting the intercostal nerve as a nerve graft: a feasibility preliminary study in cadavers.

Endoscopic surgical procedures in plastic surgery have been applied in numerous aesthetic and reconstructive surgical techniques. The use of the endoscopic video-assisted technique in peripheral nerve surgery is one of the most recent advances in reconstructive surgery. In this preliminary report, the seventh intercostal nerve, in fresh human cadavers, was harvested with the aid of endoscopy through a single 2-cm transverse incision. The anatomy of the intercostal nerve and the endoscopic surgical technique are described in this report. Multiple intercostal nerve grafts of adequate size, number, and length could be harvested, with less donor site morbidity, and used for future reconstruction of the injured peripheral nerve. The advantages of using an endoscopic technique to harvest the intercostal nerve include a magnified, clear, and illuminated visualization; a better remote access incision site; and an atraumatic technique, which may be proven particularly applicable in clinical procedures in patients who are prone to hypertrophic scars such as in women and children.

Cadaver