Very informative sir, thank you, In your experience, which proximal suture gives better glide? Pulvertaft or Kessler? And which is more prone for rerupture?
This technique is good but unfavourable result on my finger after surgery..I can't straighten my finger after this procedure. There is problem at PIP joint may be due to fds stump . I have been suffering from swan neck deformity for past 7 years
Apparently, when journals started, there was a common journal. The Journal of the American College of Surgeons (JACS) is the official scientific publication of the American College of Surgeons (ACS) now. It was formerly known as Surgery, Gynecology & Obstetrics (1905-1994), in which many great surgeons had published their path breaking works, like Bunnell! Interesting, isn't it!
Loved the video. One doubt sir You told that if we leave the fds stump too short it will lead to swan neck deformity.. how does a longer length of fds prevent swan neck ... I Couldnt understand. Waiting for next session on staged reconstruction.
The FDS is an important support for the PIP joint on volar side. When it is lost, there is a weakness on the flexor side. When you leave about 1 cm of FDS stump, it will cross the PIP joint. Any raw tendon end will not stay like that, it will get stuck to its surroundings. So the stump of FDS will get stuck to the neck of PPX which is not yielding, and prevent hyperextension deformity. If the stump is very short, the stump will get stuck to the volar plate which is a mobile structure, hence, the anterior support to the PIP joint will not be increased..
Great educational video. I have a question i hope you can answer this, I couldn’t find any answers on google. Do you know what happens if you leave the lacerated tendon untreated? And how many days can be delayed since laceration before surgery is no longer an option? I accidentally cut my zone two ring finger a few months ago i went to the er they just sutured the wound and didn’t tell me to comeback i thought my inability to clench my zone 1 ring finger joint was part of a cut so i thought id let it heal but it’s been months and I can’t afford surgery in the US right now, i can’t even go to work. I just turned 20 years old. I love boxing and working out but I can’t lift much weight and clench my fists. It’s been really hard lately i hope you can answer some of the questions thank you.
The lacerated tendon can be repaired at whatever stage, immediately, a little later at 2 weeks, or if that had not been possible, any time after 3 months, when all the joints have become soft and the scars are also soft. After 3 months, repair may not be possible, but they will need to put in a graft between the two ends of the cut tendon, which have both shrunk and moved away from each other. I hope your question has been answered.
@@lunamoon5104 Hopefully. The surgery must be done at the correct time, correct immobilisation in POP, and most importantly, good and correct physiotherapy!
Thank u sir for the video After cutting and leaving fds stump of around 1 cm is ter any chance of adhesion the fdp tension if we leave it as such or do we need to anchor t to nearby suture to prevent this sir
@@shamsudeenabdullah In case of Fascia lata graft for multiple finger tendon grafting, there are 2 techniques. If you are able to isolate the proximal tendons - (not necessarily FDP, if FDP is not good, you can also put to FDS), you can do individual grafts (4 separate slips cut from the fascia lata graft) for the fingers in the technique described in the video. If there is a common tendon proximally - for example the FDP, we must do proximal suturing first to the common part of fascia lata graft, then attach the 4 slips to the distal FDP - so first proximal, then distal.
@@GKHandSurgery thank u sir in case of common proximal tendon suturing how much tfl should be left as bulk proximally before splitting into slips sir How to mark point b and c on tfl graft since it s a flat tendon sir
@ Shivangi Saha, that video was taken under the RU-vid Channel "Learning General Surgery" and it will be uploaded on that Channel first by the admins. After that, I shall upload a link to that video on this Channel!
