SHARPN is a collaborative dedicated to providing high quality surgical education to trainees and surgeons around the world. We provide education on all matters to do with basic surgery, as well as more specialist areas in Plastic, Hand and Nerve Surgery.
Значит этот синдром без операции не лечится.??? А я все видео упражнения каждый день выполняю с надеждой, что в один прекрасный день этот синдром исчезнет😢
My 5 year child diagnosis with tendon injury she had a glass cut on her ankle of foot in emergency they stitch the injured area and now after 10 days of trauma the doctors diagnose the tender injured n suggested to reopen the wound n surgery .is it safe to undergrow surgical process for 5 year child
Hi and thank you. We are unable to give medical advice on RU-vid regarding your child unfortunately, but in general the main question in the ankle you have to ask your doctor is which specific tendon has been injured, what function is lost and do the risks of surgery and anesthesia outweigh the benefits of repair.
Thank you so much . they did not mentioned anything just said this need a surgery to fix and did not had any mri of her foot just done an xray and examine her foot her foot n finger can move downward but she has to struggle to lift her thumb
Too many foreign bodies in the epitendinous repair. I think the Kessler’s or modified Kessler’s for me, is still the gold standard. Thanks for the excellent demonstration.
Thank you, the epitendinous suture is actually an adjunct to the core suture which could be a Kessler, they are not used independent of each other. The epitendinous suture adds around 30% to the strength of your repair, and only really needs to be used in flexors distal to zone V.
@@sharpnsurgery Oh great. Thanks for this reply. For epitendinous sutures I have hitherto used simple or continuous 5/0 or 6/0 prolene sutures, but will try this technique next time.
@@kendaddi5857 yes we would usually use a 5-0, maybe 6-0 in a little finger flexor or child. The continuous epitendinous is just as good and actually like you say has less suture foreign material reaction and might be better than the silferskiold according to more recent studies, so it's fine to stick to a continuous epitendinous suture.
yea I do not understand how doctors still doing open carpal tunnel surgery release, do your research, with all these technologies there are other procedures this days that makes recovery much faster
There is always a place for newer minimal access techniques, and we do them as well, but patient selection is important. As a specialist nerve surgery unit, we also see all the complications from these newer minimal access procedures that haven't been around long enough to have obtained enough of a safety profile, and risking the possibilities of nerve pain for life for short term quicker recovery is a choice not everyone might want to make as the outcome at 3 months are the same for both procedures. There are also a lot of places which might not be able to afford the newer technologies.
You will have to gradually do it, and elevate your hand as much as you can to reduce the swelling and then you can mobilise more. Consult your doctor if you are having problems as issues like Complex Regional Pain Syndrome should be identified and treated early.
Not if you are a good distance away which you will be if you're on the scalp, and if you raise the flap completely so that it rotates instead of advances. And the burrows triangle or back cut further takes tension off the eyebrow, but you're right, one will have to be aware of the eyebrow and tailor your flap to protect it from disruption so very good question.
Thank you for your question. The short answer is yes, they heal and "re seal" themselves through intrinsic and extrinsic means. The sutures provide strength while they heal so that the ends are approximated and rehabilitation and moving the tendon is possible to prevent adhesions and stiffness. The tendon is fully healed to around 80% of the original strength at 12 weeks and the patient can return to all previous activity. At this point if you were to (hypothetically) do an operation to cut and remove the sutures, it would make no difference to the integrity of the tendon.
Hello, I would be very happy if you could help me. I had stitches on my arm 13 years ago. My wrist tendon was stitched. Do you think the stitches on my wrist tendon are the type of stitches that dissolve? The other day I felt a pain in my arm and something appeared inside. I did some research. And there were 2 pieces of sewing thread left that had not melted. I removed one of them myself because it was just under the skin, but I couldn't even touch a piece of it and couldn't remove it any further. If I go to the surgeon now, can they remove this? So this rope is not connected to the tendon or anything, right? Do you think it will be a problem? The aid I used was a blue colored rope. Thanks for
Hi, the suture that was used to repair your tendon was likely the blue suture you see, which is usually non-dissolvable. The tendon is fully healed in 3 months, so 13 years down the line if you remove the suture it shouldn't cause any problems, but yes a surgeon would be able to remove your suture for you if it is extruding/showing now.
@@sharpnsurgery Thank you for your answer, but I don't remember getting stitches on my tendon. I feel a bulge when I touch the tendon. Does that mean there's a seam there? So the glass was on my arm. The tendon in my arm remained as it was, that is, the glass did not cut the tendon, but in such a case, does the tendon still need to be stitched again?
Hi, the sutures are being demonstrated on pig fat, it is the rind/fat of a piece of pork chop which has been cut in half. The hollow plastic tube is just the protective tube that comes with disposable forceps/scissors to protect the tip.
Please tell me how long it takes for the tendon to return to normal or as it was before because I had my right knee tendon cut and then surgically reattached. Please tell me how long it will take to recover
Hi, the tendons in the hand are different to the knee tendons. A repaired flexor tendon will only get back to being about 80% as strong as it was structurally, although this will not be obvious clinically and one should be able to regain full power. The recovery is slow the tendon is weakest from 1-2 weeks after repair, then gets stronger up to 8 weeks when splints are usually discontinued and only applied at night and full recovery is complete at 12 weeks, where return to full activity, heavy lifting and contact sports can be resumed. The knee tendon, will be different and might have a longer rehabilitation period depending on which tendon is cut.
@@sharpnsurgery Thank you very much. My tendon below my knee was cut a lot with ceramic cutter glander, the day after the cut I had surgery to attach it then put 42 pins in the upper part now how long will it take to heal and after how long can I join heavy work please Please let me know if I do any heavy work before the scheduled time, is there a risk of tearing the tendons that have been reattached?
@@sharpnsurgery If I ask the person who is doing the surgery or to meet him, it takes 30 thousand in Bangladeshi taka because I am in Saudi Arabia and at the moment I don't have any money to ask him. So I asked you if I could know anything, it would be helpful. I am 24 years old. And now I am unemployed after the operation, all the money I had was spent on the operation, so I can no longer go to the doctor
Hello, I had surgery done on zone 5 (right before middle knuckle). Its been a few years now, and from what i remember he did not use stitches, and he shortened the tendon to much because it very uncomfortable to close my fist
Dear Chill Dudie, It's unlikely you have had a tendon repair if they didn't use sutures. More likely you have had a laceration with no tendon injury but the healing has caused scarring which has stuck to the tendons a little bit and it is tight when you close your fist because it pulls on the tight scarred area. The initial treatment for this is physio therapy and if still a problem surgery to release the scarring and adhesions.
I have a in-dept question about the tensile strength of these four suture methodes. - How much force is required to break the thread? As in, barely moving the finger to making a fist or making a clenched fist. - How much force is required to break the healing bond between the two tendon ends? This implies the elasticity between the bond location and the thread hole strength. Meaning that the hole in which the thread goes, ruptures open. Looking forward to your reply!
Dear odi, The sutures hold enough tensile strength to perform early active mobilisation, so it should not break with barely moving the finger but making a fist immediately after an extensor tendon repair is not recommended and will break the suture. Your second question is talking about the suture cutting through the tendon I believe this is reduced due to the techniques used where the loops grasp.the longitudinal fibres , hence it tightens when pulls if done correctly, if you would do an interrupted suture along the fibres very little force would be required for the hole the suture is in to rip open.
