Abstract:
:Previous investigations have demonstrated the superior strength and toughness of the MGH four-strand tendon repair technique and shown that it neither weakens during maximum tendon softening nor interferes with healing in an in vivo rabbit model. In the current study, the biomechanical performance of the modified Becker (MGH) and the modified Kessler repairs were compared in situ using a dynamic human cadaveric model to evaluate strength, toughness, glide efficiency, and operator variability. Three different surgeons performed a total of 42 zone II flexor digitorum profundus repairs in 14 fresh human cadaver hands. The modified Becker (MGH) repairs were stronger (79 +/- 3 versus 64 +/- 4 N; p < 0.01) and tougher (0.092 +/- 0.002 versus 0.078 +/- 0.003 J; p < 0.01) than the Kessler repairs while allowing equally efficient glide (32 +/- 6 versus 33 +/- 4 percent; p > 0.9). Strength was operator-dependent only for the modified Kessler repair (p < 0.005). We then established the optimal configuration of the MGH tenorrhaphy (number of preloaded crosses on either side of the tendon transection) by examining gap resistance ex vivo. Fifty-one MGH flexor tendon repairs were performed on explanted fresh human cadaver tendons. The experimental groups were randomly assigned to receive 0, 1, 2, 3, or 4 crosses on each side of the tenorrhaphy. Strength and toughness to gap formation and to ultimate failure were assessed tensiometrically. The MGH two-cross configuration was most resistant to gap formation (peak load 39 +/- 3 N; p < 0.05), establishing this configuration as the optimal design of this four-strand crisscrossing repair technique. The augmented Becker (MGH) repair is significantly stronger and tougher than the modified Kessler repair and demonstrates no operator dependence. It is a superior technique for zone II tenorrhaphy in the human hand. An algorithm is presented as a systematic approach that includes the important elements necessary for the rigorous biomechanical evaluation of any tendon repair technique.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Wassermann RJ,Howard R,Markee B,Payne W,Ondrovic L,Lee W,Greenwald DPsubject
Has Abstractpub_date
1997-05-01 00:00:00pages
1688-94issue
6eissn
0032-1052issn
1529-4242journal_volume
99pub_type
杂志文章abstract:BACKGROUND:To achieve the desired refinements in Asian patients, sufficient septal cartilage is needed for ideal tip projection and lengthening of the nose by the septal extension supported by the stable septum. There are many cases of insufficient septal cartilage in Asian patients. For optimal outcome, the author pro...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000001107
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:Microsurgical anastomosis of the dorsal artery of the penis either with or without anastomosis of the cavernosal artery is the preferred technique for penile replantation. However, postoperative penile skin necrosis is commonly reported with this technique. This study aimed to characterize the anatomy of the...
journal_title:Plastic and reconstructive surgery
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journal_title:Plastic and reconstructive surgery
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更新日期:2004-06-01 00:00:00
abstract:BACKGROUND:Previous studies have proposed that the frontal branch of the superficial temporal artery could be used to determine the course of the temporal branch of the facial nerve; however, these studies have not documented this relationship. The objective of this study was to thoroughly examine the courses of the fr...
journal_title:Plastic and reconstructive surgery
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doi:10.1097/01.prs.0000174001.95115.9e
更新日期:2005-08-01 00:00:00
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journal_title:Plastic and reconstructive surgery
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abstract::Gracilis functioning free-muscle transplantation for the correction of pure facial paralysis has been a preferred method used by many reconstructive microsurgeons. However, for complex facial paralysis, the deficits include facial paralysis along with soft-tissue, mucosa, and/or skin defects. No adequate solution has ...
journal_title:Plastic and reconstructive surgery
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,meta分析
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journal_title:Plastic and reconstructive surgery
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doi:10.1097/00006534-200111000-00011
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.PRS.0000095946.90511.1D
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:Transversus abdominis plane blocks are increasingly being used in microvascular breast reconstruction. The implications of these blocks on specific reconstructive, patient, and institutional outcomes remain to be fully elucidated. METHODS:Patients undergoing abdominally based microvascular breast reconstruc...
journal_title:Plastic and reconstructive surgery
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
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更新日期:2014-10-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198604000-00026
更新日期:1986-04-01 00:00:00
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journal_title:Plastic and reconstructive surgery
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更新日期:2011-09-01 00:00:00
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更新日期:2020-06-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181addbbd
更新日期:2009-08-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.PRS.0000100811.71958.A5
更新日期:2004-02-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
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journal_title:Plastic and reconstructive surgery
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更新日期:2008-01-01 00:00:00
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journal_title:Plastic and reconstructive surgery
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199309001-00018
更新日期:1993-09-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197902000-00016
更新日期:1979-02-01 00:00:00
abstract::An operative technique is described for the treatment of large lesions of erythroplasia of the penis. The defect on the glans and on the coronary sulcus is covered by a flap prepared from the external part of the prepuce. This therapy has been effective and has given a good functional result. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197705000-00003
更新日期:1977-05-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198406000-00026
更新日期:1984-06-01 00:00:00
abstract::The purpose of this study was to evaluate the immediate effect on capillary blood flow of surgical mobilization of 15 cm of the rabbit sciatic and tibial nerve. Capillary nerve blood flow was determined with 16-micron radioactive microspheres. Thirty-seven rabbits were divided into six groups. In the control group A (...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199709000-00013
更新日期:1997-09-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/01.prs.0000479998.49928.71
更新日期:2016-03-01 00:00:00
abstract::The creation of a neoumbilicus is a common challenge for plastic surgeons. The authors present their technique of umbilical reconstruction with bilateral square "pumpkin-teeth" advancement flaps. The technique described is applicable in both the setting of a vertical midline incision and when no midline incision is pr...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
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更新日期:2018-01-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
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更新日期:2004-02-01 00:00:00
abstract::A series of 40 free groin flap transfers is reviewed and analyzed with regard to the factors influencing success or failure. Emphasis is placed on the patterns of venous anastomosis used, and the use of autogenous vein grafts in the arterial limb. The series was too small to establish that any one of the 4 types of ve...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197907000-00007
更新日期:1979-07-01 00:00:00