Treatment of Flexor Tendon Reconstruction Failures: Multicentric Experience with Brunelli Active Tendon Implant

Overview

Journal Eur J Orthop Surg Traumatol

Specialty Orthopedics

Date 2017 Dec 9

PMID 29218649

Citations 3

Authors

A Poggetti

M Novi

M Rosati

D Ciclamini

M Scaglione

B Battiston

Affiliations

Soon will be listed here.

Abstract

Introduction: Secondary repair of flexor tendon injuries remain a challenging procedure for hand surgeons. Usually, secondary reconstruction should be performed by staged approach. When the tendon and pulley integrity are intact, tenolysis may be the first surgical option. One-/two-stage tendon grafts are suggested when the integrity of flexor tendon is compromised. Active tendon implants (Brunelli prostheses) may represent an efficient option in patients with a poor prognosis, as well as whenever classical techniques fail. Due to lack of literature about this second-line treatment, the authors present the experience of two different orthopedic departments with the permanent active tendon implant.

Materials And Method: Nineteen consecutive patients with failed previous flexor tendons repairs were treated with active tendon implants between 2000 and 2011. The functional outcome of the patients was examined with a mean follow-up of 5.6 years, using Strickland assessment and QuickDASH.

Results: In 16 cases, the tendon implants were well tolerated and patients resulted satisfied with a QuickDASH score less than 33. Strickland score was fair to excellent in 10 patients. We registered adhesion complications in 3 cases.

Conclusion: We can conclude that these prostheses represent an alternative to biological reconstructions and a potentially permanent procedure in complicated flexor tendon injuries.

Level Of Evidence: Multicentric case series, Level IV.

Citing Articles

Tension Stimulation of Tenocytes in Aligned Hyaluronic Acid/Platelet-Rich Plasma-Polycaprolactone Core-Sheath Nanofiber Membrane Scaffold for Tendon Tissue Engineering.

Chen C, Li D, Chuang A, Dash B, Chen J Int J Mol Sci. 2021; 22(20).

PMID: 34681872 PMC: 8537129. DOI: 10.3390/ijms222011215.

Feasibility of Homodigital Flexor Digitorum Superficialis transposition, a new technique for A2-C1 pulleys reconstruction: A kinematic cadaver study.

De Vitis R, Passiatore M, Cilli V, Lazzerini A, Marzella L, Taccardo G J Orthop. 2020; 21:483-486.

PMID: 32982105 PMC: 7498708. DOI: 10.1016/j.jor.2020.09.001.

[Secondary reconstruction of flexor tendons].

Langer M, Wieskotter B, Oeckenpohler S, Unglaub F, Spies C, Grunert J Unfallchirurg. 2019; 123(2):114-125.

PMID: 31822942 DOI: 10.1007/s00113-019-00747-9.

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