Download PDF
CC BY 4.0 · Indian J Plast Surg
DOI: 10.1055/s-0044-1792128
Case Report

Vascularized Palmaris Longus Tendon Graft in Delayed Tendon Injuries of Hand

Yog Raj Handoo
1   Department of Plastic Surgery, RD Plastic Surgery Center, New Delhi, India
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Abstract

Delayed tendon injuries of the hand often require auto tendon grafts, the success depending largely on tendon type, its own synovial cover or provided by tendon bed, and tendon bed vascularity. Tendon graft healing has been extensively studied, where tendon does increase its vascular response to trauma, attrition, or degeneration. Initially surviving through synovial fluid imbibition, followed by vascular invasion from surrounding tissues. Tendon grafts without synovial covering or in hypovascular/scarred beds have increased vascular response in the form of flimsy tissue which vascularises tendon grafts but later, they become adhesions, restricting tendon movement and final functional finger results. To overcome this hypovascular state, tendon grafts are substituted with vascularized tendon grafts. We present two cases of vascularized palmaris tendon graft in delayed tendon injuries of hand having hypovascular tendon beds, along with operative technique and results along discussion and conclusion.

Keywords

vascularized tendon graft - vascularized palmaris tendon graft


Publication History

Article published online:
19 November 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Strickland JW. Development of flexor tendon surgery: twenty-five years of progress. J Hand Surg Am 2000; 25 (02) 214-235
    CrossrefPubMedSearch in Google Scholar
  • 2 Matthews JP. Vascular changes in flexor tendons after injury and repair: an experimental study. Injury 1977; 8 (03) 227-233
    CrossrefPubMedSearch in Google Scholar
  • 3 Richards HJ. Repair and healing of the divided digital flexor tendon. Injury 1980; 12 (01) 1-12
    CrossrefPubMedSearch in Google Scholar
  • 4 Gelberman RH. Flexor tendon physiology: tendon nutrition and cellular activity in injury and repair. Instr Course Lect 1985; 34: 351-360
    PubMedSearch in Google Scholar
  • 5 Chen J, Tang JB. Complications of flexor tendon repair. J Hand Surg Eur Vol 2024; 49 (02) 158-166
    CrossrefPubMedSearch in Google Scholar
  • 6 Lowers PJ, Zelouf D, Williams C, Gelberman RH, Seiler III JG. Flexor tendon grafting to the hand: an assessment of the intrasynovial donor tendon-A preliminary single-cohort study. J Hand Surg Am 2000; 25 (04) 721-730
    CrossrefPubMedSearch in Google Scholar
  • 7 Cavadas PC. Batrizpradial, recons of FPL tendon with vascularized pedicled FDS on branch of ulnar artery. Plast Reconstr Surg Glob Open 2023; 11: e4853
    CrossrefPubMedSearch in Google Scholar
  • 8 Fenwick SA, Hazleman BL, Riley GP. The vasculature and its role in the damaged and healing tendon. Arthritis Res 2002; 4: 252-260
    CrossrefPubMedSearch in Google Scholar
  • 9 Kasperczyk WJ, Bosch U, Oestern HJ, Tscherne H. Staging of patellar tendon autograft healing after posterior cruciate ligament reconstruction. A biomechanical and histological study in a sheep model. Clin Orthop Relat Res 1993; (286) 271-282
    PubMedSearch in Google Scholar
  • 10 Wong R, Alam N, McGrouther AD, Wong JK. Tendon grafts: their natural history, biology and future development. J Hand Surg Eur Vol 2015; 40 (07) 669-681
    CrossrefPubMedSearch in Google Scholar
  • 11 Guimberteau JC, Bakhach J, Panconi B, Rouzaud S. A fresh look at vascularized flexor tendon transfers: concept, technical aspects and results. J Plast Reconstr Aesthet Surg 2007; 60 (07) 793-810
    CrossrefPubMedSearch in Google Scholar
  • 12 Durand S, Christen T, Diot R. Reconstruction using vascularized extensor indicis proprius tendon. Hand Surg Rehabil 2021; 40 (03) 224-230
    CrossrefPubMedSearch in Google Scholar
  • 13 Sunil V, Rajann S, Gitanjali JK, Kadaba J. Variations in the insertion of palmaris Longus tendon. Singapore Med J 2015; 56 (01) 7-9
    CrossrefPubMedSearch in Google Scholar
  • 14 Shen GX, Li QF. Clinic applications of vascularized plantaris tendon grafting [in Chinese]. Zhonghua Zheng Xing Wai Ke Za Zhi 2003; 19 (04) 251-253
    PubMedSearch in Google Scholar
  • 15 Moriyama M. Vascularized tendon grafting in the rabbit. J Reconstr Microsurg 1992; 8 (02) 83-91
    Thieme ConnectPubMedSearch in Google Scholar
  • 16 Vermeylen J, Monballiu G. The use of the extensor indicis proprius as a vascularised tendon graft. A preliminary report. J Hand Surg [Br] 1991; 16 (02) 185-186
    CrossrefPubMedSearch in Google Scholar
  • 17 Morrison WA, Cleland H. Vascularised flexor tendon grafts. Ann Acad Med Singap 1995; 24 (4, Suppl): 26-31
    PubMedSearch in Google Scholar
  • 18 Singer DI, Morrison WA, Gumley GJ. et al. Comparative study of vascularized and nonvascularized tendon grafts for reconstruction of flexor tendons in zone 2: an experimental study in primates. J Hand Surg Am 1989; 14 (01) 55-63
    CrossrefPubMedSearch in Google Scholar
  • 19 Cavadas PC, Mir X. Single-stage reconstruction of the flexor mechanism of the fingers with a free vascularized tendon flap: case report. J Reconstr Microsurg 2006; 22 (01) 37-40
    Thieme ConnectPubMedSearch in Google Scholar
  • 20 Cavadas PC. Reconstruction of flexor pollicis tendon with vascularised tendon with ulnar artery preservation. J Hand Surg Eur Vol 2015; 40: 259-268
    CrossrefPubMedSearch in Google Scholar