Summary
The authors present the results of their surgical experience based on an original
approach in secondary reconstructing 71 flexor tendons of the hand. For 20 years,
they have been using vascularized tendon transfers either islanded or as free transfers.
Their techniques are based on extensive knowledge of the sliding mechanisms involved
around the flexor tendons, for which the authors have developed new scientific explanations
resulting from their observations and the fine analysis of movements. This sliding
system has a multimicrovacuolar, multifibrillar architecture that is able to accommodate
every request for movement. By performing vascularized transfers, the authors also
transfer the sliding capability together with the tendon itself, thereby avoiding
the two traditional stages of tendon reconstruction. Results are better than with
the traditional techniques and the gain in time is considerable. Moreover, the biological
and physical advantages of transferring living structures are such that the functional
outcome in secondary interventions is much better. Furthermore, the wide variety of
transfers available offers possibilities for reconstruction that are better suited
to the range of presentations encountered in this challenging area of surgery. This
new approach to reconstruction is reserved for complex clinical cases and experienced
surgeons.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Plastic, Reconstructive & Aesthetic SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Critical evaluation of flexor-tendon healing and adhesion formation within artificial digital sheath.J. Bone Joint Surg. 1963; 45A: 1217
- The role of the synovial fluid and tendon sheath for flexor tendon nutrition.Scand J Plast Reconstr Surg. 1980; 14: 99
- Free tendon grafts in secondary flexor tendon repair.Am J Surg. 1947; 74: 315
- Artificial tendons. Their early development and application. In: Proceedings of the American Society for Surgery of the Hand.J Bone Joint Surg. 1965; 47A: 631-632
- Résultats du traitement des lésions multiples des tendons fléchisseurs des doigts par greffe effectuée en deux temps.Rev Chir Orthop Repar. 1972; 58: 481
- The decades of tendon surgery.in: American Academy of Orthopedic Surgeons Symposium on Tendon Surgery. Mosby, St. Louis1975
- La vascularisation des tendons.in: Tubiana R. Traité de la Chirurgie de la Main. vol. 1. Masson, Paris1986: 375-380
- Mesotendons of digital flexor muscles and their vasculature.Hand. 1981; 13: 231
- Intravital observation on the microvascular anatomy and microcirculation of the tendon.Acta Orthop Scand Suppl. 1969; 126: 23
- New ideas in hand surgery; island vascularized flexor tendon transfers, the sliding system Aquitaine Domaine Forestier.2-84023-268-5 Institut Aquitain de la Main, 56 allée des Tulipes. Pessac 336002001http://www.livres-medicaux.com(210 p)Date: 2001
- Subcutaneous tissue function: the multimicrovacuolar absorbing sliding system in hand and plastic surgery.in: Siemonov Maria Z. Tissue Surgery. New Techniques in Surgery. Springer, 2006: 41-54 ([Chapter 4])
- Introduction to the knowledge of subcutaneous sliding system in humans.Ann Chir Plast Esthet. February 2005; 50 ([Microchirurgie]): 19-34
- Mesovascularized island flexor tendon: new concepts and techniques for flexor tendon salvage surgery.Plast Reconstr Surg. 1993; 92: 888-903
- Tendon ulnar artery and island flap in hand surgery: technique, indications.Eur J Plast Surg. 1989; 12: 12
- The reverse ulnar artery forearm island flap in hand surgery: about 54 cases.Plast Reconstr Surg. 1988; 81: 925
- Recalcitrant nonunion of the scaphoid treated with a vascularized bone graft on the ulnar artery.J Bone Joint Surg. 1990; 72: 88
- Flexor tendon grafts in the fingers and thumb: an evaluation of end results.J Bone Joint Surg. 1950; 32A: 489
- Digital function following flexor tendon repair in zone II: A comparaison of immobilization and controlled passive motion techniques.J Hand Surg. 1980; 5: 537-543
- Results of flexor tendon surgery in zone II in flexor tendon surgery.Hand Clin. 1985; 1: 167-179
- Homologous composite tissues grafts of the digital flexor mechanism in human beings.Transplant Bull. 1960; 7: 418
- Human allotransplant of a digital flexion system vascularized on the ulnar pedicle: a preliminary report and 1-year follow-up of two cases.Plast Reconstr Surg. 1992; 89 (35, 1): 11
Article info
Publication history
Published online: April 28, 2007
Accepted:
February 6,
2007
Received:
October 20,
2006
Identification
Copyright
© 2007 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
