Project: Research project

Project Details


DESCRIPTION (Adapted from the Applicant's Abstract): Recovery of flexor
tendon gliding after tendon laceration and repair within the fibro-osseous
pulley system remains a difficult problem. In particular, injuries in Zone
2 produce significant loss of functional strength and motion after repair.
Adhesions often restrict the normal excursion of the tendon. After repair,
early mobilization of the tendon is crucial in prevention of post-operative
adhesions. Passive mobilization techniques are currently preferred, but,
because passive flexion may result in tendon buckling within the sheath,
these may not produce complete gliding of the tendon within the sheath, even
under ideal conditions. This buckling, in turn, may depend upon the degree
of gliding resistance, or friction, within the tendon sheath. The purpose
of this study is to compare the gliding resistance of commonly used methods
to repair human flexor digitorum profundus (FDP) tendon, with the gliding
resistance of a normal tendon, by direct measurement at the tendon-pulley
interface. The protocol will test the hypothesis that adequate gliding of
the repaired tendon by passive mobilization can only be accomplished if the
gliding resistance is overcome by the passive motion protocol. The proposal
will also test the hypothesis that if adequate gliding is truly
accomplished, then post-operative adhesions will be reduced. Finally, it
will evaluate the effect of postoperative rehabilitation on tendon repair
breaking strength. Human cadaver specimens will be used for the initial in
vitro assessment of gliding resistance. A canine model will then be adopted
for both the in vitro, and in vivo evaluation. The combination of human and
canine testing of similar repairs, in vitro, will permit some point of
comparison for the canine in vivo results. Thus, if repairs behave
similarly in vitro, in dogs and humans, it may be reasonable to expect that
canine in vivo results may predict human in vivo (i.e., clinical) findings.
A method recently developed and validated by the applicant laboratory will
be used to measure gliding resistance between tendon and pulley. The
concept of synergistic wrist motion, developed and validated in the past few
years, will be adopted for post-operative mobilization to achieve tendon
Effective start/end date1/1/981/31/15


  • Medicine(all)