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Karelson M, Launonen AP, Jokihaara J, Havulinna J, Mattila VM. Pain, function, and patient satisfaction after arthroscopic treatment of elbow in a retrospective series with minimum of 5-year follow-up. J Orthop Surg (Hong Kong) 2020; 27:2309499019832808. [PMID: 30827185 DOI: 10.1177/2309499019832808] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The clinical indications for elbow arthroscopic procedures have expanded through last decades. The aim of the study was to assess the functional results and patient satisfaction after arthroscopic treatment of various elbow conditions after a minimum 5-year follow-up. METHODS We conducted a retrospective study of a consecutive patient cohort who had undergone unilateral elbow arthroscopy between 2008 and 2010. The main outcomes were Disabilities of the Arm, Shoulder and Hand (DASH) score and a specific patient-reported outcome measure questionnaire after a minimum 5-year follow-up. RESULTS In total, there were 93 patients in the cohort with different diagnoses. Majority of patients were suffering from elbow osteoarthrosis. After the average follow-up of 72 months (range 60-96 months), the response rate was 67%. Eighty two percent of patients were satisfied with the pain relief and locking of the elbow was relieved in 70% of patients. Elbow range of motion (ROM) improved in 80% of the 55 patients who had a limited ROM before the operation. The overall patient satisfaction after elbow arthroscopic treatment was good. There were no differences in median DASH score between patients with or without post-traumatic condition, but the median DASH score for patients who had severe (grade 3) osteoarthrosis before the operation was significantly worse. There were no major complications reported in this cohort. CONCLUSIONS Arthroscopic treatment of various elbow conditions was associated with good patient satisfaction and reduced symptoms without major complications. Level of Evidence: Level IV, therapeutic case series.
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Affiliation(s)
- Margit Karelson
- 1 Department of Hand Surgery, Tampere University Hospital, Tampere, Finland
| | - Antti P Launonen
- 2 Department of Orthopaedics and Traumatology, Tampere University Hospital, Tampere, Finland
| | - Jarkko Jokihaara
- 1 Department of Hand Surgery, Tampere University Hospital, Tampere, Finland.,3 The School of Medicine, University of Tampere, Tampere, Finland
| | | | - Ville M Mattila
- 2 Department of Orthopaedics and Traumatology, Tampere University Hospital, Tampere, Finland.,3 The School of Medicine, University of Tampere, Tampere, Finland
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Linnanmäki L, Göransson H, Havulinna J, Karjalainen T, Leppänen OV. Factors Accounting for Variation in the Biomechanical Properties of Flexor Tendon Repairs. J Hand Surg Am 2018; 43:1073-1080.e2. [PMID: 30292714 DOI: 10.1016/j.jhsa.2018.08.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 06/26/2018] [Accepted: 08/20/2018] [Indexed: 02/02/2023]
Abstract
PURPOSE To investigate factors that cause variation in the mechanical properties of flexor tendon repairs. METHODS One surgeon repaired 50 homogeneous absorbent sticks and 40 porcine flexor tendons with a simple loop, an Adelaide repair, a peripheral over-and-over repair, or a combination of the latter 2 repairs. Ten hand surgeons repaired 1 porcine flexor tendon with the combined Adelaide core and over-and-over peripheral repair. We loaded the samples statically until failure and calculated the variations caused by the testing process, tendon substance, and surgical performance in terms of yield and ultimate load. RESULTS Tendon material and surgical performance both caused about half of the variation in the yield load of the combined repair. Surgical performance caused all variations observed in the ultimate load of the combined, peripheral-only, and core repairs. The effect of the tendon material was negligible in ultimate load. The intersurgeon variation was present only in yield load, and it represented one-tenth of the total variation. CONCLUSIONS The effect of tendon substance on variation of the ultimate load is minimal. In yield load, both tendon and surgical performance are responsible for the variation. CLINICAL RELEVANCE In clinical realm, variation caused by testing is not present, but intersurgeon variation may cause additional variation in yield load. A hand surgeon cannot change the variation due to tendon properties, but with a more meticulous surgical technique, the variation related to the surgical performance can probably be diminished.
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Affiliation(s)
- Lasse Linnanmäki
- Department of Hand and Microsurgery, University of Tampere, Faculty of Medicine and Life Sciences and Tampere University Hospital, Tampere, Finland
| | - Harry Göransson
- Department of Hand and Microsurgery, University of Tampere, Faculty of Medicine and Life Sciences and Tampere University Hospital, Tampere, Finland
| | | | - Teemu Karjalainen
- Department of Surgery, Central Finland Central Hospital, Jyväskylä, Finland
| | - Olli V Leppänen
- Department of Hand and Microsurgery, University of Tampere, Faculty of Medicine and Life Sciences and Tampere University Hospital, Tampere, Finland.
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Linnanmäki L, Göransson H, Havulinna J, Sippola P, Karjalainen T, Leppänen OV. Gap Formation During Cyclic Testing of Flexor Tendon Repair. J Hand Surg Am 2018; 43:570.e1-570.e8. [PMID: 29395582 DOI: 10.1016/j.jhsa.2017.12.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 10/25/2017] [Accepted: 12/04/2017] [Indexed: 02/02/2023]
Abstract
PURPOSE Substantial gap formation of a repaired finger flexor tendon is assumed to be harmful for tendon healing. The purpose of this study was to investigate the relationship between gap formation and the failure of the repair during cyclic loading. METHODS Thirty-five porcine flexor tendons were repaired and tested cyclically using variable forces until failure or a maximum of 500 cycles. Depending on the biomechanical behavior during cyclic testing, specimens were divided into 3 groups: Sustained (no failure), Fatigued (failure after 50 cycles), and Disrupted (failure before 50 cycles). The relationships between the gap formations, time-extension curves, and group assignments of the samples were investigated. RESULTS The time-extension curves of the Fatigued specimens showed a sudden onset of repair elongation-a fatigue point-which preluded the subsequent failure of the repair. This point coincides with the start of plastic deformation and, thereafter, cumulative injury of the repair consistently led to failure of the repair during subsequent cycles. None of the sustained repairs showed a fatigue point or substantial gapping during loading. CONCLUSIONS We conclude that the emergence of a fatigue point and subsequent gap formation during loading will lead to failure of the repair if loading is continued. CLINICAL RELEVANCE The results of this experimental study imply that an inadequate flexor tendon repair that is susceptible to gap formation is under risk of failure.
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Affiliation(s)
- Lasse Linnanmäki
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Harry Göransson
- Department of Hand and Microsurgery, Tampere University Hospital, Tampere, Finland
| | | | - Petteri Sippola
- Department of Mechanical Engineering and Industrial Systems, Tampere University of Technology, Tampere, Finland
| | | | - Olli V Leppänen
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland; Department of Hand and Microsurgery, Tampere University Hospital, Tampere, Finland.
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Leppänen OV, Karjalainen T, Göransson H, Hakamäki A, Havulinna J, Parkkinen J, Jokihaara J. Outcomes After Flexor Tendon Repair Combined With the Application of Human Amniotic Membrane Allograft. J Hand Surg Am 2017; 42:474.e1-474.e8. [PMID: 28365148 DOI: 10.1016/j.jhsa.2017.03.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 02/27/2017] [Accepted: 03/06/2017] [Indexed: 02/02/2023]
Abstract
PURPOSE Clinically proven methods to prevent adhesion formation after flexor tendon repair have not yet been established. The aim of this pilot study was to assess the feasibility of amniotic membrane allograft as a mechanical barrier to decrease adhesion formation. METHODS Ten patients having flexor tendon injuries were planned to be recruited to the pilot study. The operative treatment consisted of tendon repair and fixation of amniotic membrane allograft around the repaired tendon. The primary outcome variable was the range of motion of the operated finger 6 months after the operation. Patients were monitored for infections and repair failures. RESULTS The study was terminated owing to unfavorable results after treatment of 5 patients. One patient had extensive stiffness and was subjected to tenolysis and joint release. Histopathological analysis of the tendon sheath revealed focal fibrosis. Another patient had a repair failure. The other 3 patients had fair to good results. CONCLUSIONS It seems improbable that the use of amniotic membrane allograft would yield clinically relevant improvement compared with the existing techniques. However, it remains unclear whether the unfavorable results are associated with technical factors, amniotic membrane allograft itself, or an irregular distribution of complications. TYPE OF STUDY/LEVEL OF EVIDENCE Therapeutic V.
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Affiliation(s)
- Olli V Leppänen
- Department of Hand- and Microsurgery, University of Tampere, Tampere, Finland; School of Medicine, University of Tampere, Tampere, Finland.
| | - Teemu Karjalainen
- Department of Surgery, Central Hospital of Central Finland, Jyväskylä, Finland
| | - Harry Göransson
- Department of Hand- and Microsurgery, University of Tampere, Tampere, Finland
| | - Annika Hakamäki
- Regea Cell and Tissue Center, BioMediTech, University of Tampere, Tampere, Finland
| | | | - Jyrki Parkkinen
- Department of Pathology, Fimlab Laboratories, Tampere, Finland
| | - Jarkko Jokihaara
- Department of Hand- and Microsurgery, University of Tampere, Tampere, Finland
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Abstract
OBJECTIVE The objective of the present study was to describe how a specific patient flow analysis with from-to charts can be used in hospital design and layout planning. BACKGROUND As part of a large renewal project at a university hospital, a detailed patient flow analysis was applied to planning the musculoskeletal surgery unit (orthopedics and traumatology, hand surgery, and plastic surgery). METHOD First, the main activities of the unit were determined. Next, the routes of all patients treated over the course of 1 year were studied, and their physical movements in the current hospital were calculated. An ideal layout of the new hospital was then generated to minimize transfer distances by placing the main activities with close to each other, according to the patient flow analysis. The actual architectural design was based on the ideal layout plan. Finally, we compared the current transfer distances to the distances patients will move in the new hospital. RESULTS The methods enabled us to estimate an approximate 50% reduction in transfer distances for inpatients (from 3,100 km/year to 1,600 km/year) and 30% reduction for outpatients (from 2,100 km/year to 1,400 km/year). CONCLUSIONS Patient transfers are nonvalue-added activities. This study demonstrates that a detailed patient flow analysis with from-to charts can substantially shorten transfer distances, thereby minimizing extraneous patient and personnel movements. This reduction supports productivity improvement, cross-professional teamwork, and patient safety by placing all patient flow activities close to each other. Thus, this method is a valuable additional tool in hospital design.
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Affiliation(s)
| | - Isto Nordback
- 2 The Pirkanmaa Hospital District, Tampere University Hospital, Tampere, Finland
| | - Jussi Elo
- 3 Consultant in Trauma and Orthopaedic Surgery, Tampere, Finland
| | | | - Heikki-Jussi Laine
- 5 Department of Orthopaedics and Traumatology, The Pirkanmaa Hospital District, Tampere University Hospital, Tampere, Finland
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Havulinna J, Jokihaara J, Paavilainen P, Leppänen OV. Keyhole Revascularization for Treatment of Coronal Plane Fracture of the Lunate in Kienböck Disease. J Hand Surg Am 2016; 41:e441-e445. [PMID: 27663052 DOI: 10.1016/j.jhsa.2016.08.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 08/19/2016] [Indexed: 02/06/2023]
Abstract
Coronal plane fracture of lunate in Kienböck disease is a challenging problem with no proven treatment. We present a technique for the treatment. A vascularized bone graft from the distal radius employing the fourth and fifth extracompartmental artery pedicles is used as a mechanical support in order to enable fracture union. The technical pearls and pitfalls are described and a clinical case is presented.
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Affiliation(s)
| | - Jarkko Jokihaara
- Department of Hand and Microsurgery, Tampere University Hospital, Tampere, Finland
| | - Pasi Paavilainen
- Department of Hand and Microsurgery, Tampere University Hospital, Tampere, Finland
| | - Olli V Leppänen
- Department of Hand and Microsurgery, Tampere University Hospital, Tampere, Finland; Medical School, University of Tampere, Tampere, Finland.
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Leppänen OV, Linnanmäki L, Havulinna J, Göransson H. Suture configurations and biomechanical properties of flexor tendon repairs by 16 hand surgeons in Finland. J Hand Surg Eur Vol 2016; 41:831-7. [PMID: 27066998 DOI: 10.1177/1753193416641624] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Accepted: 02/24/2016] [Indexed: 02/03/2023]
Abstract
The aim of this study was to find out how common it is to modify standard core suture configurations in flexor tendon repair and whether the use of standard core suture configurations gives a stronger repair. A total of 16 hand surgeons or residents participated in a workshop, in which they were asked to draw the suture configurations they used and to repair a porcine tendon. The properties of the repaired tendons were measured. Seven participants used a standard core suture configuration, and nine used a modified core suture. The biomechanical properties of the repairs were not affected by modifications to the core suture. However, they were affected by the number and lengths of peripheral suture bites, type of peripheral suture and the location of the core suture knot.
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Affiliation(s)
- O V Leppänen
- Department of Hand- and Microsurgery, Tampere University Hospital, Tampere, Finland Medical School, University of Tampere, Tampere, Finland
| | - L Linnanmäki
- Medical School, University of Tampere, Tampere, Finland
| | - J Havulinna
- Department of Hand- and Microsurgery, Tampere University Hospital, Tampere, Finland
| | - H Göransson
- Department of Hand- and Microsurgery, Tampere University Hospital, Tampere, Finland
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Linnanmäki L, Göransson H, Havulinna J, Sippola P, Karjalainen T, Leppänen OV. Validity of parameters in static linear testing of flexor tendon repair. J Biomech 2016; 49:2785-2790. [PMID: 27395758 DOI: 10.1016/j.jbiomech.2016.06.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 06/13/2016] [Accepted: 06/18/2016] [Indexed: 10/21/2022]
Abstract
To study the biomechanical properties of flexor tendon repairs, static tensile testing is commonly used because of its simplicity. However, cyclic testing resembles the physiological loading more closely. The aim of the present study is to assess how the biomechanical competence of repaired flexor tendons under cyclic testing relates to specific parameters derived from static tensile testing. Twenty repaired porcine flexor tendons were subjected to static tensile testing. Additional 35 specimens were tested cyclically with randomly assigned peak load for each specimen. Calculated risks of repair failure during repetitive loading were determined for mean of each statically derived parameter serving as a peak load. Furthermore, we developed a novel objective method to determine the critical load, which is a parameter predicting the survival of the repair in cyclic testing. The mean of statically derived yield load equalled the mean of critical load, justifying its role as a valid surrogate for critical load. However, regarding mean of any determined parameter as a clinically safe threshold is arbitrary due to the natural variation among samples. Until the universal performance of yield load is verified, we recommend employing cyclically derived critical load as primary parameter when comparing different methods of flexor tendon repair.
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Affiliation(s)
| | - Harry Göransson
- Department of Hand and Microsurgery, Tampere University Hospital, Tampere, Finland
| | - Jouni Havulinna
- Department of Hand and Microsurgery, Tampere University Hospital, Tampere, Finland
| | - Petteri Sippola
- Department of Mechanical Engineering and Industrial Systems, Tampere University of Technology, Tampere, Finland
| | - Teemu Karjalainen
- Department of Surgery, Central Hospital of Central Finland, Jyväskylä, Finland
| | - Olli V Leppänen
- Medical School, University of Tampere, Tampere, Finland; Department of Hand and Microsurgery, Tampere University Hospital, Tampere, Finland.
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Leppänen OV, Jokihaara J, Kaivorinne A, Havulinna J, Göransson H. Protocol for an investigator-blinded, randomised, 3-month, parallel-group study to compare the efficacy of intraoperative tendon sheath irrigation only with both intraoperative and postoperative irrigation in the treatment of purulent flexor tenosynovitis. BMJ Open 2015; 5:e008824. [PMID: 26671952 PMCID: PMC4679920 DOI: 10.1136/bmjopen-2015-008824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The management of purulent flexor tenosynovitis of the hand consists of surgical debridement followed by antibiotic treatment. Usually, the debridement is carried out by irrigating the tendon sheath in a proximal to distal direction facilitated by two small incisions. It is unclear whether intraoperative irrigation by itself is adequate for healing or if it should be combined with postoperative irrigation in the ward. The hypothesis of this prospective randomised trial is that intraoperative catheter irrigation alone is as effective as a combination of intraoperative and postoperative intermittent catheter irrigation in the treatment of purulent flexor tenosynovitis. METHODS AND ANALYSIS In this investigator-blinded, prospective randomised trial, 48 patients suffering from purulent flexor tenosynovitis are randomised in two groups. Intraoperative catheter irrigation of the flexor tendon sheath and antibiotic treatment is identical in both groups, whereas only the patients in one group are subjected to intermittent postoperative catheter irrigation three times a day for 3 days. The primary outcome measure is total active range of movement of the affected finger after 3 months of surgery. The secondary outcome is the need for reoperation. ETHICS AND DISSEMINATION The research ethics committee of Pirkanmaa Hospital District has approved the study protocol. The protocol has been registered with ClinicalTrials.gov registry (#NCT02320929). All participants will give written informed consent. The study results will elucidate the role of postoperative irrigation, which can be criticised as being labour consuming and unpleasant to the patient. The results of the study will be disseminated as a published article in a peer-reviewed journal. TRIAL REGISTRATION NUMBER NCT02320929; pre-results.
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Affiliation(s)
- Olli V Leppänen
- Department of Hand and Microsurgery, Tampere University Hospital, Tampere, Finland
| | - Jarkko Jokihaara
- Department of Hand and Microsurgery, Tampere University Hospital, Tampere, Finland
| | - Antti Kaivorinne
- Department of Hand and Microsurgery, Tampere University Hospital, Tampere, Finland
| | - Jouni Havulinna
- Department of Hand and Microsurgery, Tampere University Hospital, Tampere, Finland
| | - Harry Göransson
- Department of Hand and Microsurgery, Tampere University Hospital, Tampere, Finland
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Abstract
In a previous study we found that the strength of a Kessler core suture in the flexor tendon was greater in flexor zone 2 than in zone 3. To further investigate the material properties of the flexor tendon without the influence of a locking suture configuration, we measured the ultimate strength of a simple loop suture in the flexor digitorum profundus tendon in zones 1, 2, and 3. Eight cadaver flexor digitorum profundus tendons were tested in 10 mm increments with a 3-0 polyester suture loop pull-out test in the mid-substance of the tendon. The mean strength in zones 1 and 2 (26.7 N, SD 5.6) was significantly higher than the mean strength in zone 3 (17.7 N, SD 5.4). We conclude that the difference is owing to variations of the structure of the flexor tendon in different sections of the tendon, as the suture configuration was a simple loop without a locking or grasping component.
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Affiliation(s)
- J Havulinna
- Division of Hand and Microsurgery, Department of Trauma, Musculoskeletal Surgery and Rehabilitation, Tampere University Hospital, FI-33521 TAYS, Tampere, Finland.
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Havulinna J. [Sore wrist]. Duodecim 2012; 128:408-412. [PMID: 22448553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A patient with a sore, stiff and swollen wrist should be referred to basic examination at the first consultation visit. Nontraumatic causes such as joint inflammation, tumors and avascular necrosis require urgent treatment. Symptomatic treatment and follow-up observation can be considered, if the anamnesis does not reveal anything indicative of severe joint disease or significant injury, and no clear-cut abnormalities are found in the wrist. Triangular fibrocartilage complex injuries and scaphoid/lunate ligament tear are the most common ligament injuries requiring surgical treatment.
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Havulinna J, Leppänen OV, Järvinen TLN, Göransson H. Comparison of modified Kessler tendon suture at different levels in the human flexor digitorum profundus tendon and porcine flexors and porcine extensors: an experimental biomechanical study. J Hand Surg Eur Vol 2011; 36:670-6. [PMID: 21816887 DOI: 10.1177/1753193411415936] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
This study compared the biomechanical behaviour of repairs in the human flexor digitorum profundus tendon in zones I, II and III with repairs of different segments of the porcine flexor tendon of the second digit and the extensor digiti quarti proprius tendon, in order to assess the validity of porcine tendons as models for human flexor tendon repairs. These porcine tendons were selected after comparing their size with the human flexor digitorum profundus tendon. The tendon repairs were done in three segments of each porcine tendon and repairs in the human tendons were done in zones I,II and III. Ten tendons in each group yielded a total of 90 specimens. A modified Kessler repair was done with 3-0 coated braided polyester suture and subjected to uniaxial tensile testing. In human flexor tendons, the ultimate force was higher in zones I and II than in zone III. The porcine flexor digitorum profundus tendon from the second digit and the proximal segment of the extensor digiti quarti proprius tendon behaved similarly to the human flexor tendon in zone III and can be considered as surrogates for the human flexor tendon.
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Affiliation(s)
- J Havulinna
- Division of Hand and Microsurgery, Department of Trauma, Musculoskeletal Surgery and Rehabilitation, Tampere University Central Hospital, Tampere, Finland.
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Viikari-Juntura E, Miintyselkii P, Havulinna J. [Elbow pain]. Duodecim 2010; 126:1945-1951. [PMID: 20957794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Pain and disability in the elbow are not as common as in the neck, shoulder or wrist, for example. The elbow may, however, present disorders that may in a prolonged state be difficult and cause significant loss of working capacity. These include epicondylitis, osteoarthritis and entrapment of the ulnar nerve.
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Abstract
Sesamoid bone disorders are rare and usually are a result of trauma or degenerative causes. Tumors of the sesamoid bones of the hand are encountered less frequently. We report a case of an aneurysmal bone cyst of the radial index sesamoid of the hand. The tumor was treated successfully by sesamoid bone resection.
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Affiliation(s)
- J Havulinna
- Department of Surgery, Division of Hand and Microsurgery, University Hospital of Tampere, Tampere, Finland.
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Havulinna J. [The skier's thumb]. Duodecim 2001; 117:520-2. [PMID: 12116780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
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Havulinna J, Lindholm TS, Lehto MU, Viljakka T, Jokio P, Kuusela T. [Osteochondrosis dissecans in the knee joint]. Duodecim 1992; 108:639-47. [PMID: 1366124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/25/2023]
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