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Designing a minimally-invasive, ultrasound-guided, percutaneous flexor tendon sheath lavage technique: a cadaver study.

Authors
  • Boyer, E1
  • Igeta, Y2
  • Jiang, S3
  • Arianni, M4
  • Goldammer, F1
  • Prunières, G1
  • Paun, A1
  • Vernet, P1
  • Liverneaux, P5
  • 1 Department of Hand Surgery, SOS main, CCOM, University Hospital of Strasbourg, FMTS, University of Strasbourg, Icube CNRS 7357, 10 avenue Baumann, 67400 Illkirch, France. , (France)
  • 2 Department of Hand Surgery, SOS main, CCOM, University Hospital of Strasbourg, FMTS, University of Strasbourg, Icube CNRS 7357, 10 avenue Baumann, 67400 Illkirch, France; Department of Orthopedic Surgery, Juntendo Nerima Hospital, 3-1-10, Takanedai, Nerima-ku, Tokyo, 177-8521, Japan. , (France)
  • 3 Department of Hand Surgery, Huashan Hospital, Shanghai Medical College, Fudan University, 138 Yixueyuan Road, Shanghai, 200040, China; Department of Hand and Upper Extremity Surgery, Jing'an District Central Hospital, No.12 Wulumuqi Middle Road, 200040, Shanghai, Popular Republic of China. , (China)
  • 4 Hand Clinic, Ramsay Premier Bintaro Hospital, Jl. MH Thamrin no.1, Bintaro Jaya sector Tangerang Selatan, 15224, Banten, Indonesia. , (Indonesia)
  • 5 Department of Hand Surgery, SOS main, CCOM, University Hospital of Strasbourg, FMTS, University of Strasbourg, Icube CNRS 7357, 10 avenue Baumann, 67400 Illkirch, France. Electronic address: [email protected] , (France)
Type
Published Article
Journal
Hand surgery & rehabilitation
Publication Date
Apr 01, 2019
Volume
38
Issue
2
Pages
87–90
Identifiers
DOI: 10.1016/j.hansur.2018.12.001
PMID: 30655220
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The goal of this study was to develop a minimally-invasive, ultrasound-guided percutaneous flexor tendon sheath lavage technique on cadaver model. Two catheters were inserted using ultrasound guidance at the proximal and distal ends of the tendon sheath in 20 fingers from cadaveric forearms. Percutaneous injection of a saline solution colored with methylene blue resulted in anterograde lavage of the flexor tendon sheath. The technique was successful in 13 out of 20 cases. The proximal catheter was in the correct position in 17 cases and the distal catheter was correctly positioned in 15 cases. The flexor tendons were continuous in all cases and had puncture wounds in 9 cases. Based on our study, this minimally-invasive, ultrasound-guided percutaneous lavage of the flexor tendon sheath was effective in 65% of cases and safe in 100% of cases in the index, middle and ring fingers. If this percutaneous lavage fails, it is always possible to switch to a conventional open technique. Copyright © 2018 SFCM. Published by Elsevier Masson SAS. All rights reserved.

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