Gliding resistance of the flexor pollicis longus tendon after repair

Does partial excision of the oblique pulley affect gliding resistance?

Keiji Kutsumi, Peter C Amadio, Chunfeng D Zhao, Mark E. Zobitz, Kai Nan An

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

BACKGROUND: After tendon repair, it is critical for the repair site to pass smoothly under the pulley edge to promote gliding and reduce the risk of adhesion or rupture. In this study, the authors assessed the effect of partial excision by "squaring off" the distal edge of the oblique pulley on the gliding resistance of the flexor pollicis longus tendon after repair in vitro. METHODS: Gliding resistance of 10 human thumbs was measured directly with three different sequential conditions: intact flexor pollicis longus tendon with intact A1 and oblique pulleys (group A), intact pulleys after repair of the tendon (group B), and after repair and excision of the distal triangular part (squaring off) of the oblique pulley (group C). RESULTS: Gliding resistance increased significantly after repair and squaring off the oblique pulley (group A, 0.22 ± 0.08 N; group B, 1.29 ± 0.68 N; and group C, 2.01 ± 0.84 N). CONCLUSIONS: Previous studies suggest that the trimming of an annular pulley in the finger would not result in any significant mechanical disadvantage if other parts of the pulley system were intact. However, the authors' results suggest that in the case of the thumb oblique pulley, gliding resistance is increased after trimming and tendon repair, and thus the oblique pulley should be left intact if possible.

Original languageEnglish (US)
Pages (from-to)1423-1428
Number of pages6
JournalPlastic and Reconstructive Surgery
Volume118
Issue number6
DOIs
StatePublished - Nov 2006

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Tendons
Thumb
DNA Repair
Fingers
Rupture

ASJC Scopus subject areas

  • Surgery

Cite this

Gliding resistance of the flexor pollicis longus tendon after repair : Does partial excision of the oblique pulley affect gliding resistance? / Kutsumi, Keiji; Amadio, Peter C; Zhao, Chunfeng D; Zobitz, Mark E.; An, Kai Nan.

In: Plastic and Reconstructive Surgery, Vol. 118, No. 6, 11.2006, p. 1423-1428.

Research output: Contribution to journalArticle

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AU - Amadio, Peter C

AU - Zhao, Chunfeng D

AU - Zobitz, Mark E.

AU - An, Kai Nan

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N2 - BACKGROUND: After tendon repair, it is critical for the repair site to pass smoothly under the pulley edge to promote gliding and reduce the risk of adhesion or rupture. In this study, the authors assessed the effect of partial excision by "squaring off" the distal edge of the oblique pulley on the gliding resistance of the flexor pollicis longus tendon after repair in vitro. METHODS: Gliding resistance of 10 human thumbs was measured directly with three different sequential conditions: intact flexor pollicis longus tendon with intact A1 and oblique pulleys (group A), intact pulleys after repair of the tendon (group B), and after repair and excision of the distal triangular part (squaring off) of the oblique pulley (group C). RESULTS: Gliding resistance increased significantly after repair and squaring off the oblique pulley (group A, 0.22 ± 0.08 N; group B, 1.29 ± 0.68 N; and group C, 2.01 ± 0.84 N). CONCLUSIONS: Previous studies suggest that the trimming of an annular pulley in the finger would not result in any significant mechanical disadvantage if other parts of the pulley system were intact. However, the authors' results suggest that in the case of the thumb oblique pulley, gliding resistance is increased after trimming and tendon repair, and thus the oblique pulley should be left intact if possible.

AB - BACKGROUND: After tendon repair, it is critical for the repair site to pass smoothly under the pulley edge to promote gliding and reduce the risk of adhesion or rupture. In this study, the authors assessed the effect of partial excision by "squaring off" the distal edge of the oblique pulley on the gliding resistance of the flexor pollicis longus tendon after repair in vitro. METHODS: Gliding resistance of 10 human thumbs was measured directly with three different sequential conditions: intact flexor pollicis longus tendon with intact A1 and oblique pulleys (group A), intact pulleys after repair of the tendon (group B), and after repair and excision of the distal triangular part (squaring off) of the oblique pulley (group C). RESULTS: Gliding resistance increased significantly after repair and squaring off the oblique pulley (group A, 0.22 ± 0.08 N; group B, 1.29 ± 0.68 N; and group C, 2.01 ± 0.84 N). CONCLUSIONS: Previous studies suggest that the trimming of an annular pulley in the finger would not result in any significant mechanical disadvantage if other parts of the pulley system were intact. However, the authors' results suggest that in the case of the thumb oblique pulley, gliding resistance is increased after trimming and tendon repair, and thus the oblique pulley should be left intact if possible.

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