The Journal of hand surgery, European volume
-
Fifty cadaver digits were used to study the mechanical properties of five different methods of pulley reconstruction and the effectiveness of three different pulley reconstructive arrangements in restoring a normal relationship between tendon excursion and joint motion. All reconstructed pulleys showed less stiffness and more displacement before failure than normal intact pulleys. Although reconstruction using a length of another tendon woven through the remaining fibrous rim of the pulley and both double and triple tendon graft loops around bone absorbed more energy to failure than a normal pulley, only the triple loop around bone could withstand as much load before failure as a normal pulley. No reconstruction restored a normal tendon excursion/joint motion relationship, but reconstruction of the A2 and A4 pulleys restored a more normal relationship than either the "belt loop" reconstruction or a combination belt loop, A2 and A4 reconstruction.
-
At the National Institute of Traumatology in Budapest, a search has been made for foreign bodies in tendons over the last 15 years. 53 foreign bodies have been found in 931 tendons removed at operation and 45 foreign bodies in 950 tendon samples at autopsy. The foreign material was found to be organic in 29 cases, metal in 20 cases and plastic in six cases. ⋯ The foreign bodies were found in the tendons of the upper extremities in 51 cases and the lower extremities in 47 cases. Foreign bodies in the tendons were more likely to cause problems in the upper limbs than in the lower limbs: these problems were purulent tendonitis, necrosis, foreign body granuloma, fibrosis and peritendonitis and calcification.
-
Wrist function was assessed between one and three years after injury in patients who had suffered Colles' fractures. Both the range of wrist flexion and the strength of grip were found to be deficient. The loss of power in gripping was found to correlate with mal-union affecting the coronal and sagittal inclination of the articular surface of the radius.