Phenytoin accelerates tendon healing in a rat model of Achilles tendon rupture.

INTRODUCTION: Tendons are vulnerable to various types of acute or chronic injures. Different methods have been investigated to achieve better healing. Phenytoin is a drug which could stimulate fibroblasts to produce collagen. This experimental study was performed to assess the effect of phenytoin on tendon healing in a rat model of tendon rupture. METHODS: Thirty healthy rats were divided into 3 groups, 1) Sham group; 2) Tendon rupture; 3) Tendon rupture+phenytoin (100 mg/kg intraperitoneally) for 21 days. On 21st day after tendon injury, the rats were anesthetized and tendon tissue was sampled for studying by light and electron microscopy. RESULTS: Qualitative and quantitative microscopic comparisons of the repair tissues of both groups were made on the 21st day. The results obtained from light and electron microscopy studies showed that tendon tissue healing was significantly better in phenytoin group compared to the control group (p < 0.05). CONCLUSIONS: Systemic administration of phenytoin may have a positive effect on tendon healing by increasing fibroblast quantity, fibrillar collagen synthesis, vascularity, and suppressing inflammation (Tab. 2, Ref. 25).

Displaced fracture of the neck of the radius with complete 180 degrees rotation of the radial head during closed reduction.

We report a case of fracture of the radial neck in a teenage girl in which 180 degrees rotation of the radial head occurred at close reduction. Although this was corrected, avascular necrosis of the radial head occurred. To our knowledge only four cases of such iatrogenic malpositioning have been described in the literature.

Zone 2 flexor tendon repair in young children: a comparative study of four-strand versus two-strand repair.

This study compares the active ranges of finger motion and rupture rates of two-strand and four-strand repairs in zone 2 flexor tendon lacerations in young children. A total of 29 patients (under the age of 4 years) with 32 flexor tendon lacerations in zone 2 were evaluated. The injured tendons were randomly repaired with either two-strand or four-strand modified Strickland techniques. At a mean follow-up period of 11 months, the mean total active motion of interphalangeal joints was 156 degrees in the two-strand and 158 degrees in the four-strand group. According to the Strickland original method, this means an average of 89% (range 57-100%) of normal function in the two-strand and 90% (range 60-100%) in the four-strand group. There were no ruptures of the four-strand repairs, but one two-strand repair failed within 3 weeks of the repair. Statistically, we were not able to show any significant difference in the active ranges of finger motion achieved with two-strand and four-strand repairs.