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J Hand Surg Am ; 42(6): 474.e1-474.e8, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28365148

RESUMO

PURPOSE: Clinically proven methods to prevent adhesion formation after flexor tendon repair have not yet been established. The aim of this pilot study was to assess the feasibility of amniotic membrane allograft as a mechanical barrier to decrease adhesion formation. METHODS: Ten patients having flexor tendon injuries were planned to be recruited to the pilot study. The operative treatment consisted of tendon repair and fixation of amniotic membrane allograft around the repaired tendon. The primary outcome variable was the range of motion of the operated finger 6 months after the operation. Patients were monitored for infections and repair failures. RESULTS: The study was terminated owing to unfavorable results after treatment of 5 patients. One patient had extensive stiffness and was subjected to tenolysis and joint release. Histopathological analysis of the tendon sheath revealed focal fibrosis. Another patient had a repair failure. The other 3 patients had fair to good results. CONCLUSIONS: It seems improbable that the use of amniotic membrane allograft would yield clinically relevant improvement compared with the existing techniques. However, it remains unclear whether the unfavorable results are associated with technical factors, amniotic membrane allograft itself, or an irregular distribution of complications. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic V.


Assuntos
Âmnio/transplante , Traumatismos dos Tendões/cirurgia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Projetos Piloto , Estudos Prospectivos , Amplitude de Movimento Articular , Técnicas de Sutura , Aderências Teciduais/prevenção & controle , Resultado do Tratamento
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