Flexor tendon grafts for pulley reconstruction - Morphological aspects
| Autor: | Maurizio Calcagni, Tim Pohlemann, Tobias Fritz, Pascal Ducommun, Wolfgang Metzger, Thomas Tschernig, Florian S. Frueh, Michael D. Menger |
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| Přispěvatelé: | University of Zurich, Frueh, Florian S |
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Materials science business.product_category genetic structures Transplants 610 Medicine & health Pulley Collagen fibril 1309 Developmental Biology Fingers Tendons 03 medical and health sciences Cadaver Humans 10266 Clinic for Reconstructive Surgery Hand function Flexor tendon General Medicine Anatomy Wrist musculoskeletal system 2702 Anatomy eye diseases 030104 developmental biology Trigger Finger Disorder Microscopy Electron Scanning sense organs 030101 anatomy & morphology business Interphalangeal Joint Developmental Biology |
| Zdroj: | Annals of anatomy = Anatomischer Anzeiger : official organ of the Anatomische Gesellschaft. 231 |
| ISSN: | 1618-0402 |
| Popis: | Background Pulleys are crucial to convert flexor tendon excursion into angular motion at the metacarpophalangeal and interphalangeal joints. Loss of pulley function can lead to significant impairment of hand function and may require surgical reconstruction. This reconstruction can be achieved using different flexor tendons grafts, such as the intrasynovial flexor digitorum superficialis (FDS) or the extrasynovial palmaris longus (PL). However, there is limited knowledge on the micromorphology of human pulleys and the suitability of flexor tendon grafts for their reconstruction remains elusive. Methods In the present cadaver study A2 and A4 pulleys were compared with FDS and PL tendons by means of scanning electron microscopy (SEM), histology and immunohistochemistry. Surface morphology, core structure and vascularization of the specimens were analyzed. Results SEM imaging of the gliding surfaces revealed morphological differences between tendons and pulleys. Moreover, the core structure of FDS samples was characterized by bundles of individual collagen fibrils whereas PL tendons exhibited a less hierarchical microstructure. In contrast, pulleys consisted of lamellar sheets of densely packed collagen fibrils. Finally, immunohistochemical analyses revealed that the flexor tendons and pulleys contain similar numbers of CD31+ microvessels, indicating a comparable tissue vascularization. Conclusion This study provides novel SEM and immunohistochemical insights into the micromorphology of human pulleys and flexor tendon grafts. Intrasynovial flexor tendons may be particularly suitable for pulley reconstruction and preserving the paratenon may be crucial for graft revascularization. |
| Databáze: | OpenAIRE |
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