Volume 12, Issue 2 (2023)                   WJPS 2023, 12(2): 41-46 | Back to browse issues page


XML Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Forghani S F, Haghighimanesh H, Ghadimi T, Akbari H, Farahmand H, Naderi Gharahgheshlagh S et al . The Clinical Efficacy of Fat Injection on the Repair of Hand Flexor Tendon: A Randomized Clinical Trial. WJPS 2023; 12 (2) :41-46
URL: http://wjps.ir/article-1-1069-en.html
1- Department of Plastic and Reconstructive surgery, Hazrat Fatemeh Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
2- Burn Research Center, Iran University of Medical Sciences, Tehran, Iran.
Abstract:   (1228 Views)
Background: In recent years, special attention has been paid to minimally invasive and conservative methods in addition to conventional surgical methods to repair tendon damage. In this regard, the effect of fat injection and graft has been of great interest due to its potential in accelerating tissue repair. We aimed to assess the clinical efficacy of fat injection along with conventional approach in patients with flexor tendon injury.
Methods: In this randomized clinical trial, 64 patients were randomly scheduled for tendon repair using the usual modified Kessler four-strand method alone or tendon repair using four-strand method and fat injection on the proximal and distal sides of the repair site in the Hazrat Fatemeh Hospital, Tehran Province, Iran in 2022 (IRCT20221206056723N1). Patients were followed-up for eight weeks regarding the function status of the repaired tendon (using Strickland grading test), range of motion (by physical examination) and flexion and extension gaps (by imaging).
Results: In the eighth weeks after the treatment, the average Strickland score was significantly higher in the group receiving fat injection (P: 0.009 ). In the two pointed times, the mean range of motion was significantly higher and the mean flexion and extension gaps were significantly lower in those who received fat injection. None of the procedural side effects were observed in the fifth and eighth weeks after the treatment.
Conclusion: Fat injection along with usual surgical treatment for tendon repair accelerates and improves tendon function and range of motion.

 
Full-Text [PDF 265 kb]   (844 Downloads)    
Type of Study: Original Article | Subject: Special
ePublished: 2023/09/23

References
1. Seif el Nasr M, Dombek G, Lowka K. Surgical therapy of frequent hand injuries. Part 2: Injuries of the tendons, neurovascular bundles and soft tissues. Fortschr Med 1993 Jan 30;111(3):37-9.
2. Weissman JP, Sasson DC, Chappell AG, Moran SL, Gosain AK. Practice Patterns in Operative Flexor Tendon Laceration Repair: A 15-Year Analysis of Continuous Certification Data from the American Board of Plastic Surgery. Plast Reconstr Surg Glob Open 2022 Oct 7;10(10):e4558. [DOI:10.1097/GOX.0000000000004558]
3. Mallina R, Bamford E, Shelton I, Selby A, Russell P, Johnson N. A Review of Outcome Reporting Practices after Flexor Tendon Repair in Zones 1 and 2.
4. J Hand Surg Asian Pac Vol 2022 Apr;27(2):226-232. [DOI:10.1142/S2424835522500357]
5. Mo YW, Ryu DH, Cho G-Y, Hong JW. Is conservative management of partial zone II flexor tendon laceration possible? A systematic literature review and meta-analysis. J Plast Surg Hand Surg 2023 Feb-Dec;57(1-6):46-53. [DOI:10.1080/2000656X.2022.2117704]
6. Warren JR, Khalil LS, Pietroski AD, Muh SJ. Injection of adipose stem cells in the treatment of rotator cuff disease-a narrative review of current evidence. Regen Med 2022 Jul;17(7):477-489. [DOI:10.2217/rme-2021-0166]
7. Kokubu S, Inaki R, Hoshi K, Hikita A. Adipose-derived stem cells improve tendon repair and prevent ectopic ossification in tendinopathy by inhibiting inflammation and inducing neovascularization in the early stage of tendon healing. Regen Ther 2020 Jan 17;14:103-110. [DOI:10.1016/j.reth.2019.12.003]
8. Colonna M, Scarcella M, do STAGNO D'ALCONTRES F, Delia G, Lupo F. Should fat graft be recommended in tendon scar treatment? Considerations on three cases (two feet and a severe burned hand). Eur Rev Med Pharmacol Sci 2014;18(5):753-9.
9. Shauly O, Gould DJ, Ghavami A. Fat Grafting: Basic Science, Techniques, and Patient Management. Plast Reconstr Surg Glob Open 2022 Mar 18;10(3):e3987. [DOI:10.1097/GOX.0000000000003987]
10. Deptula P, Block T, Tanabe K, Kulber D. Autologous Fat Grafting in the Upper Extremity: Defining New Indications. Plast Reconstr Surg Glob Open 2022 Aug 19;10(8):e4469. [DOI:10.1097/GOX.0000000000004469]
11. Deptula P, Fox P. Autologous Fat Grafting in Hand Surgery. J Hand Surg Am 2021;46(7):594-600. [DOI:10.1016/j.jhsa.2021.02.015]
12. Bruin LL, Lans J, Wang F, Eberlin KR, Chen NC. Reoperation Following Zone II Flexor Tendon Repair Hand (N Y) 2022 Feb 26;15589447211043220. [DOI:10.1177/15589447211043220]
13. Abu-Ghname A, Perdanasari AT, Reece EM. Principles and applications of fat grafting in plastic surgery. Semin Plast Surg 2019 Aug;33(3):147-154. [DOI:10.1055/s-0039-1693438]
14. Taha AA, El Deen AN, Ragab M, Ali RA. Flexor tendon repair outcomes with fat grafting. European Journal of Plastic Surgery 2021;44(2):237-42. [DOI:10.1007/s00238-020-01716-x]
15. Behfar M, Javanmardi S, Sarrafzadeh-Rezaei F. Comparative study on functional effects of allotransplantation of bone marrow stromal cells and adipose derived stromal vascular fraction on tendon repair: a biomechanical study in rabbits. Cell Journal (Yakhteh) 2014;16(3):263. Cell J. 2014 Fall;16(3):263-70.
16. Lu L-Y, Ma M, Cai J-F, et al. Effects of Local Application of Adipose-Derived Stromal Vascular Fraction on Tendon-Bone Healing after Rotator Cuff Tear in Rabbits. Chin Med J (Engl) 2018 Nov 5;131(21):2620-2622. [DOI:10.4103/0366-6999.244120]
17. Polly SS, Nichols AE, Donnini E, et al. Adipose-derived stromal vascular fraction and cultured stromal cells as trophic mediators for tendon healing. J Orthop Res 2019 Jun;37(6):1429-1439. [DOI:10.1002/jor.24307]
18. El Rayes J, Sader RB, Moutran M, Rassi S, Boueri W. Biologically Enhanced Hamstring Tendon Transfer for Treatment of Acute Rupture of Posterior Tibialis Tendon in an Athlete: Case Report. J Foot Ankle Surg 2019 Jul;58(4):647-652. [DOI:10.1053/j.jfas.2018.07.014]

Add your comments about this article : Your username or Email:
CAPTCHA

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2024 CC BY-NC 4.0 | World Journal of Plastic Surgery

Designed & Developed by : Yektaweb