Flexor Tendon Injury
Conditions
Keywords
flexor tendon, finger, amniotic membrane, allograft, tendon injury
Brief summary
The objective of this pilot study is to gain observational insight into potential preventive features of amniotic membrane transplantation in the adhesion formation after flexor tendon repair.
Detailed description
The treatment of flexor tendon transection consists of surgical apposition of the lacerated tendon ends using non-absorbable sutures. Main complications which result in poor outcome of the tendon repair are the rupture of the tendon apposition or substantial adhesion formation between the two tendons or the tendon and the fibro-osseous canal. Adhesion formation is presumed to be a byproduct of the tendon healing. In the course of last 70 decades, the preventive effects of several pharmacological agents and mechanical barriers on adhesion formation have been investigated with some promising findings. One of the mechanical barriers that has been proposed to be suitable for adhesion prevention is human amniotic membrane allograft. However, there are no clinical studies evaluating the use of amniotic membrane in flexor tendon repair. This is a pilot study for the forthcoming randomized controlled study. The objectives of the pilot study are: 1) to test the handleability of the human amniotic membrane allograft in flexor tendon sheath reconstruction in conjunction with flexor tendon repair, 2) to elucidate the possible adverse effects related to the use of amniotic membrane in flexor the sheath, and 3) to gain observational insight into potential preventive features of amniotic membrane transplantation in the adhesion formation. The hypothesis of the pilot study is that the application of the human amniotic membrane allograft in tendon sheath reconstruction in flexor tendon injury patients is technically feasible and results in no adverse effects to the patient. A total of 10 patients with an acute flexor tendon injury will be included in the pilot study. After conventional tendoraphia, the amniotic membrane will be wrapped around the tendons and its borders will be fixed to the remaining tendon sheath. The primary outcome measure is total range of movement after 6 months of the surgery.
Interventions
PROCEDUREThe use of amnionic membrane allograft
After the conventional flexor tendon repair, the amniotic membrane will be wrapped around the tendons and its borders will be fixed to the remaining tendon sheath.
Sponsors
Tampere University Hospital
Central Finland Hospital District
Tampere University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Acute flexor tendon transection in zone 2 in digits 2, 3, 4, or 5 (diagnosed within 1 week after the injury) * Age over 18 * Patient's willingness to participate in the study
Exclusion criteria
* Tendon transection within 8 mm of its distal insertion (requiring reinsertion) * Soft-tissue loss, severe crush, fracture, palmar plate injury, patient requiring revascularization * Cognitive impairment or other factors (prisoner, military serviceman) which may affect one's decision making * Substance abuse * Pregnancy
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Total range of movement of the injured finger | 6 months |
Secondary
| Measure | Time frame |
|---|---|
| Total range of movement of the injured finger | 2, 4, and 8 weeks |
| Rupture of the repair | 2, 4, 8 weeks, and 6 months |
| Postoperative infection | 2, 4, 8 weeks, and 6 months |
| QuickDASH -score | 2, 4, 8 weeks, and 6 months |
Countries
Finland
Outcome results
None listed