Evidence map›Paper›PMID 26310324›Full record

ReviewDer Orthopade2015

[Tenolysis of the flexor tendons in the hand].

T Pillukat, R Fuhrmann, J Windolf, J van Schoonhoven

Abstract readEnglish AbstractReview
PubMed Publisher
In one paragraph

Review in Der Orthopade, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

T PillukatKlinik für Handchirurgie Bad Neustadt an der Saale, Salzburger Leite 1, 97616, Bad Neustadt an der Saale, Deutschland. t.pillukat@handchirurgie.de.
R FuhrmannKlinik für Fußchirurgie Bad Neustadt an der Saale, Bad Neustadt an der Saale, Deutschland.
J WindolfKlinik für Unfall- und Handchirurgie, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland.
J van SchoonhovenKlinik für Handchirurgie Bad Neustadt an der Saale, Salzburger Leite 1, 97616, Bad Neustadt an der Saale, Deutschland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundProperly gliding flexor tendons is mandatory for the normal functioning of the finger and thumb. Any damage to tendons, tendon sheath or adjacent tissue can lead to the formation of adhesions that inhibit the normal gliding function. If adhesions limit the digital function and adequate hand therapy does not provide further progress, then surgical intervention should be considered.

aimThe authors' strategy and treatment algorithm for flexor tenolysis are presented in the context of the current literature.

methodsThere is no absolute indication for flexor tenolysis. The decision should be made in a motivated patient who has access to adequate postoperative hand therapy. It should be based on healed fractures and osteotomies, mature soft tissue coverage, intact tendons and gliding tissues, and a full range of passive flexion, and preferably extension of the affected joints. The principle of flexor tenolysis is the consequent resection of all adhesive tissue around the tendon inside and outside the tendon sheath, with preservation of as many pulley sections as possible. Therefore, extensive approaches are frequently necessary. Arthrolysis and the resolution of unfavorable scars, the resection of scarred lumbricals, and pulley reconstruction are additional procedures that are frequently performed.

resultsIn the literature, improvement in the range of motion is between 59 and 84 %. Good and excellent functional results are reported in 60-80 % of the cases. Nevertheless, in selected cases, functional deterioration occurs. Flexor tendon ruptures after tenolysis were observed in 0-8 % of the patients. DISCUSSION: With regard to complications such as secondary tendon ruptures, loss of pulleys, and scar formation, flexor tenolysis is part of a reconstructive ladder that includes further procedures. In the case of failure or complications, salvage procedures such as arthrodesis, amputation, and ray resection or staged flexor tendon reconstruction including tendon grafting are recommended. After successful flexor tenolysis long-term hand therapy for at least 3-6 months is mandatory to maintain the intraoperative gain of function.

Indexed as

Combined Modality TherapyExercise TherapyHand InjuriesHumansPlastic Surgery ProceduresTendon InjuriesTendonsTenotomyTissue AdhesionsFingersHand injuriesReconstructive surgical proceduresRecovery of functionTissue adhesions

Identifiers

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.