10 minute presentation on extensor tendons of the hand going through the nuances, anatomy, and principles of repair in various zones as well as technique demonstration of the modified kessler and common errors.
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.
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.
Hi Lostfruit. If you sustained an extensor tendon injury, you should go to the emergency department immediately so you can be referred for treatment to a hand or plastic surgeon in a timely manner. If these injuries are delayed they are very hard to treat.
