Medical Minute 4-25: Fixing Tendons

By: Vanessa Welch Email
By: Vanessa Welch Email

He's the stay-at-home dad of an active two-year-old. 47-year-old Wallis Gopilall definitely has his hands full, but a year ago, Wallis lost the use of his left hand. He accidentally cut his left forefinger to the bone, severing his tendon.

"I thought I was going to lose a finger. It wasn't straight. It was bent like this, so I thought I'd lose part of the finger. You don't know the use of it until something happens and then you have to use it back again and you can't," he said.

Fore tendon injuries, studies show standard sutures aren't always a strong enough fix.

"Tendons that are fixed with sutures, regular sutures, you cannot move them on your own. They will rupture right away," said Wadih Macksoud, M.D., Orthopedic Hand Surgeon at Jewett Orthopedics.

For Wallis's injury, Doctor Wadih Macksoud used a system specially designed for tendon repair. A tiny corkscrew-shaped anchor is placed at each end of the severed tendon. Then, a braided steel suture is inserted through the anchor on each end for a strong, permanent fix.

"So, now what you have tendon, tendon and a cable between them that is fixed to the inside of the tendon and that thing is solid enough that you can fix the tendon and start the patient moving from day one."

Wallis knows he has to stay in shape to better keep up with his little one, but his hand is definitely better.

For more information on other series produced by Ivanhoe Broadcast News contact John Cherry at (407) 691-1500,


BACKGROUND: Hand injuries account for between 5 percent and 10 percent of visits to the emergency room. Soft tissue injuries of the hand are rarely life-threatening, but there is a high incidence of disability from chronically painful or unstable joints. In fact, hand derangements account for 9 percent of all worker compensation claims. Trauma accounts for the majority of these injuries. However, patients may also have complaints that are secondary to infection, burns or overuse.
(SOURCE: eMedicine)

OTHER TYPES OF INJURIES: There are 27 muscles and 27 bones in each hand and wrist. As a result, the hand is very flexible, strong and able to perform fine movements. Hand and finger injuries are common in sports that have a high risk of falling such as skiing, biking, skating and gymnastics. Hand and finger injuries are typically caused by accidents that are difficult to prevent. These include broken bones, dislocations and sprains. A fall, direct impact, or a twisting or bending motion can cause one of these injuries. A backward bending of the thumb can cause a portion of the bone to break off. A thumb sprain is a stretch, tear or complete rupture of one of the ligaments that connect the bones of the thumb together. Mallet finger occurs when a muscle that extends to the end of one of the fingers completely rips away, leaving the last part of the finger crooked. There are two types of jammed fingers. A "slight" jam means that the cushion between the joint is injured, which causes swelling. With the second type, the joint dislocates and stretches or tears ligaments that normally hold the finger bones together. Flexor tendonitis is an injury that causes irritation and pain to the muscles of the forearm.
(SOURCE: The University of Iowa Hospitals and Clinics)

SEVERED TENDONS: Injuries that involve a severed tendon in the finger may affect the entire hand. Studies show standard sutures aren't always strong enough to fix these injuries. Now, doctors are using the Teno Fix System. It uses a novel soft-tissue anchor system and a multifilament stainless steel suture. The soft-tissue anchor is installed into each end of the tendon, gathering collagen fibers as it turns. A suture is then inserted through the anchor and the severed tendon ends are reattached. The Teno Fix System is FDA-approved and is used in medical centers around the United States.

Tinisha Jones
Jewett Orthopaedics
Orlando, FL

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