External Thermoplastic Rings Restore Near-normal Flexor Tendon Biomechanics Following Venting of the Pulleys

Description

The presentation by Assaf Kadar, a fellow at the Roth, focuses on a research study exploring the use of external thermoplastic rings to restore flexor tendon biomechanics following the venting of pulleys during surgical procedures. He opens by addressing the importance of flexor tendon pulley venting, which has gained traction in recent years due to new research and advancements in surgery that demonstrate it can be done without negatively impacting clinical outcomes. However, there remains a belief among some surgeons that pulleys have essential anatomical and biomechanical roles.



Kadar details the challenges faced during surgeries, particularly when a surgeon vents the pulley too much, leading to tendon bowstringing. He proposes a simpler solution of applying a thermoplastic ring to emulate the function of the original pulley, effectively aiding in finger movement and restoring biomechanics to what he describes as a near-normal state.



The study uses an advanced hand simulator in the mechatronics lab to measure finger movement following the application of pulley rings after sequential venting of pulleys A2, A3, and A4. Preliminary results indicated a decrease in range of motion with each venting, but the application of the rings helped restore motion substantially, showing that the therapy may be a viable option for surgical practice.



Kadar acknowledges the limitations of cadaver studies and potential variables, such as patient comfort and individual biomechanics, yet emphasizes the potential of his approach as a non-invasive, cost-effective solution for restoring tendon function. He concludes by encouraging further clinical studies to validate their biomechanical findings.

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