TY - JOUR
T1 - Gliding resistance of the flexor pollicis longus tendon after repair
T2 - Does partial excision of the oblique pulley affect gliding resistance?
AU - Kutsumi, Keiji
AU - Amadio, Peter C.
AU - Zhao, Chunfeng
AU - Zobitz, Mark E.
AU - An, Kai Nan
N1 - Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2006/11
Y1 - 2006/11
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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U2 - 10.1097/01.prs.0000239595.97189.54
DO - 10.1097/01.prs.0000239595.97189.54
M3 - Article
C2 - 17051113
AN - SCOPUS:33750224454
SN - 0032-1052
VL - 118
SP - 1423
EP - 1428
JO - Plastic and reconstructive surgery
JF - Plastic and reconstructive surgery
IS - 6
ER -