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DOI: 10.1055/s-0044-1792128
Vascularized Palmaris Longus Tendon Graft in Delayed Tendon Injuries of Hand
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.
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/)
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References
- 1 Strickland JW. Development of flexor tendon surgery: twenty-five years of progress. J Hand Surg Am 2000; 25 (02) 214-235
- 2 Matthews JP. Vascular changes in flexor tendons after injury and repair: an experimental study. Injury 1977; 8 (03) 227-233
- 3 Richards HJ. Repair and healing of the divided digital flexor tendon. Injury 1980; 12 (01) 1-12
- 4 Gelberman RH. Flexor tendon physiology: tendon nutrition and cellular activity in injury and repair. Instr Course Lect 1985; 34: 351-360
- 5 Chen J, Tang JB. Complications of flexor tendon repair. J Hand Surg Eur Vol 2024; 49 (02) 158-166
- 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
- 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
- 8 Fenwick SA, Hazleman BL, Riley GP. The vasculature and its role in the damaged and healing tendon. Arthritis Res 2002; 4: 252-260
- 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
- 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
- 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
- 12 Durand S, Christen T, Diot R. Reconstruction using vascularized extensor indicis proprius tendon. Hand Surg Rehabil 2021; 40 (03) 224-230
- 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
- 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
- 15 Moriyama M. Vascularized tendon grafting in the rabbit. J Reconstr Microsurg 1992; 8 (02) 83-91
- 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
- 17 Morrison WA, Cleland H. Vascularised flexor tendon grafts. Ann Acad Med Singap 1995; 24 (4, suppl): 26-31
- 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
- 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
- 20 Cavadas PC. Reconstruction of flexor pollicis tendon with vascularised tendon with ulnar artery preservation. J Hand Surg Eur Vol 2015; 40: 259-268