Suroto, Heri and Satmoko, Benedictus Anindita and Rarasati, Twindy and Prajasari, Tabita (2023) Long term functional outcome evaluation in post flexor digitorum profundus tendon zone I rupture repaired by palmaris longus tendon grafting augmented with human amniotic membranes and adipose derived mesenchymal stem cell: A case report. International Journal of Surgery Case Reports, 104 (107960). ISSN 22102612
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Abstract
Introduction and importance
The sport climbing has many complex maneuvers of the hand producing many potential injuries in flexor digitorum profundus tendon (FDPT). The late management due to an athlete high demand on competition makes the complication of retracted tendon and adhesion tend to occur. We provide the long terms functional outcome in FDPT zone I rupture repaired by palmaris longus (PL) tendon grafting augmented with human amniotic (hAM) and adipose derived mesenchymal stem cell (ASCs).
Case presentation
We present a case of a 31-years old male sport climbing athlete with excruciating pain in the right middle finger due to an injury at distal phalangeal area occurred two months earlier. Intraoperatively, Bruner's incision was performed for exploration. A modified Kessler suture technique with running sutures around the sutured stump was used. We slightly overcorrected tension between PL and FDPT distal stumps. We shielded the distal and proximal sutured areas with hAM augmented with ASCs. The result was remarkable as he could return to competitive sport.
Clinical discussion
Zones I and II have a high adhesion risk due to their complex structures. In the case of the PL tendon graft, the sutured stump lies in these zones which can affect outcomes. An HAM augmented with ASCs has an anti-adhesive property that allows smooth gliding of the tendon FDPT on two sutured stump junctions, as well as stimulating the tendon to produce tenocytes, which accelerates tendon healing.
Conclusion
The combination of our technique and regenerative therapy effectively prevents adhesions and modulates tendon healing.
Item Type: | Article |
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Uncontrolled Keywords: | Flexor digitorum profundus tendon rupture; Regenerative therapy; Tendon healing; Human amniotic membrane; Adipose mesenchymal stem cell; Case report |
Subjects: | R Medicine > R Medicine (General) R Medicine > RD Surgical Divisions |
Divisions: | Faculty of Medicine, Public Health and Nursing > Non Surgical Divisions |
Depositing User: | Maniso Maniso |
Date Deposited: | 22 May 2024 07:45 |
Last Modified: | 22 May 2024 07:45 |
URI: | https://ir.lib.ugm.ac.id/id/eprint/1333 |