Search Our Scientific Publications & Authors

Clin Rheumatol 2020 May 16. Epub 2020 May 16.

Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, via Sergio Pansini 5, 80131, Naples, Italy.

Objective: To assess the effectiveness of steroid injection (local treatment, LT) into the digital flexor tendon sheath of dactylitis in psoriatic arthritis (PsA) patients as compared with systemic treatment (ST).

Methods: Forty-six PsA patients with a total of 73 dactylitic fingers were assessed in an observational, multicentre, prospective study by the Leeds Dactylitis Index basic (LDI-b) score and evaluated for local pain (visual analogue scale-VAS pain) and functional impairment (VAS-FI). Steroid injection was proposed to all patients. Read More

Hand Surg Rehabil 2020 May 7. Epub 2020 May 7.

Orthopedic Department, HaEmek Medical Center, Yitshak Rabin Boulevard 21, 1834111 Afula, Israel; Faculty of Medicine, Technion, 3200003 Haifa, Israel. Electronic address:

The second case of high temperature molten metal, high-pressure injection injury of the hand is reported here. Like in the previous case, there was an innocent-looking entry point with deep thermal injury to the flexor tendons and the digital nerves that appeared a few days after the injury and lead to finger amputation. LEVEL OF EVIDENCE: 5. Read More

Equine Vet J 2020 Apr 17. Epub 2020 Apr 17.

Department of Clinical Sciences, College of Veterinary Medicine, Université de Montréal, St. Hyacinthe, Quebec, Canada.

Background: The effect of intrathecal anaesthesia of the carpal sheath on distal forelimb sensitivity in horses remains unknown.

Objectives: To assess the effect of carpal sheath anaesthesia on skin sensitivity of the distal forelimb and to determine potential locations for desensitisation of palmar nerves.

Study Design: In vivo experimental and descriptive anatomical studies. Read More

PLoS One 2020 15;15(4):e0231619. Epub 2020 Apr 15.

Department of Orthopedics, Balgrist University Hospital, Zurich, Switzerland.

Background: Tendinopathy is a common musculoskeletal disorder and current treatment options show limited success. Genipin is an effective collagen crosslinker with low cytotoxicity and a promising therapeutic strategy for stabilizing an intratendinous lesion.

Purpose: This study examined the mechanical effect and delivery of intratendinous genipin injection in healthy and degenerated tendons. Read More

Tissue Eng Part C Methods 2020 May 5;26(5):253-262. Epub 2020 May 5.

Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, Illinois, USA.

Histological evaluation of healing tendons is primarily focused on monitoring restoration of longitudinal collagen alignment, although the elastic property of energy-storing flexor tendons is largely attributed to interfascicular sliding facilitated by the interfascicular matrix (IFM). The objectives of this study were to explore the utility of second harmonic generation (SHG) imaging to objectively assess cross-sectional tendon fascicle architecture, to combine SHG microscopy with elastin immunofluorescence to assess the ultrastructure of collagen and elastin in longitudinal and transverse sections, and lastly, to quantify changes in IFM elastin and fascicle collagen alignment of normal and collagenase-injured flexor tendons. Paraffin-embedded transverse and longitudinal histological sections (10-μm thickness) derived from normal and collagenase-injured (6- and 16-week time-points) equine superficial digital flexor tendons were de-paraffinized, treated with Tris EDTA at 80°C for epitope retrieval, and incubated with mouse monoclonal anti-elastin antibody (1:100 dilution) overnight. Read More

Tech Hand Up Extrem Surg 2019 Dec;23(4):196-198

Department of Orthopedic Surgery and Sports Medicine, University of Kentucky.

Collagenase injections are used as a minimally invasive treatment for Dupuytren contracture of the palm and fingers, with good published success. Most complications are related to injection-site swelling, pain, and ecchymosis. However, the risk of flexor tendon and digital nerve injury can occur when injecting cords that cause proximal interphalangeal joint contractures. Read More

Stem Cell Res Ther 2019 06 18;10(1):181. Epub 2019 Jun 18.

Division of Physiology, Department of Basic Sciences, Faculty of Veterinary Medicine, Ferdowsi University of Mashhad, Mashhad, Iran.

Tendon injuries, as one of the most common orthopedic disorders, are the major cause of early retirement or wastage among sport horses which mainly affect the superficial digital flexor tendon (SDFT). Tendon repair is a slow process, and tendon tissue is often replaced by scar tissue. The current treatment options are often followed by an incomplete recovery that increases the susceptibility to re-injury. Read More

Vet J 2019 May 23;247:26-31. Epub 2019 Feb 23.

Environmental and Radiological Health Sciences Department, Colorado State University, 300 W. Drake Rd., Fort Collins, CO 80523, USA.

Injuries to the structures within the digital flexor tendon sheath (DFTS) can lead to lameness with a variable degree of effusion in horses. In some cases, effusion is absent or minimal, and this may be related to the chronicity and type of injury, or veterinary interventions. The purpose of this study was to determine if saline injection into the DFTS would improve ultrasonographic and magnetic resonance imaging of the distal limb without introducing artifact. Read More

Open Vet J 2018 15;8(4):471-478. Epub 2018 Dec 15.

Dipartimento di Medicina Veterinaria, Centro Clinico Veterinario e Zootecnico Sperimentale, Università degli Studi di Milano, Italy.

The use of contrast enhanced magnetic resonance imaging (MRI) for the detection of orthopedic pathologies in equine patients is poorly described. In few studies, enhanced MRI allowed to differentiate active lesions from chronic ones and to classify ambiguous lesions. The aim of this clinical prospective pilot study is to describe and compare the MRI lesions observed in horses with lameness localized to the foot using a single intravenous bolus dose of gadolinium contrast versus regional intraarterial bolus of contrast agent. Read More

Anat Histol Embryol 2018 Dec 6;47(6):537-543. Epub 2018 Aug 6.

Anatomy and Embryology Department, Faculty of Veterinary Medicine, Sadat-City University, Sadat City, Egypt.

The camel digits have a complex structure with tendons, joints and ligaments. The objective of the study was to determine the anatomical features of the metatarsophalangeal joint and its puncture site in dromedary camel using anatomical dissection, radiography, computed tomography (CT) bone and soft tissue window scans and 3D reconstruction render volume of CT. The study used six adult camels of both sexes (three males and three females), aged 9-15 years (Mean ± SD equal 11. Read More

Hand Clin 2018 08 8;34(3):387-394. Epub 2018 Jun 8.

Hand Surgery Service, Department of Orthopaedics, Yawkey Center, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA. Electronic address:

Dupuytren contracture is a progressive disease involving collagen within the palmar fascia. When the contracture progresses to meet specific parameters, intervention is considered and includes collagenase injection, percutaneous or open fasciotomy, or palmar fasciectomy. Complications after treatment include contracture recurrence, digital nerve injury or postoperative neurapraxia, flexor tendon injury/rupture, delayed wound healing or skin necrosis, dysvascular digit/arterial injury, hematoma, and infection. Read More

Stem Cell Res Ther 2018 06 19;9(1):169. Epub 2018 Jun 19.

Royal Veterinary College, Hawkshead Lane, Hatfield, AL9 7TA, UK.

Background: Intra-synovial tendon injuries display poor healing, which often results in reduced functionality and pain. A lack of effective therapeutic options has led to experimental approaches to augment natural tendon repair with autologous mesenchymal stem cells (MSCs) although the effects of the intra-synovial environment on the distribution, engraftment and functionality of implanted MSCs is not known. This study utilised a novel sheep model which, although in an anatomically different location, more accurately mimics the mechanical and synovial environment of the human rotator cuff, to determine the effects of intra-synovial implantation of MSCs. Read More

PLoS One 2018 9;13(3):e0191796. Epub 2018 Mar 9.

Centre d'Imagerie et de Recherche sur les Affections Locomotrices Equines, Ecole Nationale vétérinaire d'Alfort, Maisons-Alfort, France.

A randomized controlled trial was performed on racing horses, to evaluate the efficacy of a new class of therapeutic agents in regenerative medicine-ReGeneraTing Agents® (RGTA®), to treat tendinopathies. Preliminary uncontrolled studies on tendon healing in racing horses with RGTA® (OTR4131)-Equitend® showed encouraging results, justifying performing a randomized, controlled, multicenter study with a two-year racing performance follow up. The objective of this study was to evaluate the effect of Equitend® versus placebo on acute superficial digital flexor tendonitis in racing French Standardbred Trotters (ST). Read More

Front Vet Sci 2017 16;4:169. Epub 2017 Oct 16.

Faculty of Science, School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, NSW, Australia.

Navicular bursa (NB) centesis is a common diagnostic and therapeutic procedure in equine practice. This case report documents the clinical, diagnostic imaging and histological findings in a horse with a suspected iatrogenic deep digital flexor tendon (DDFT) injury following centesis of the NB a modified distal plantar approach (placement of two needles in a weight bearing position). Although it cannot be proven with absolute certainty, the authors believe that this is the first reported case where NB centesis is the likely cause of a DDFT lesion, and with magnetic resonance imaging performed both pre- and post-centesis. Read More

Front Vet Sci 2017 26;4:158. Epub 2017 Sep 26.

Global Stem Cell Technology, ANACURA Group, Evergem, Belgium.

Poor healing of tendon and ligament lesions often results in early retirement of sport horses. Therefore, regenerative therapies are being explored as potentially promising treatment for these injuries. In this study, an intralesional injection was performed with allogeneic tenogenically induced mesenchymal stem cells and platelet-rich plasma 5-6 days after diagnosis of suspensory ligament (SL) ( = 68) or superficial digital flexor tendon (SDFT) ( = 36) lesion. Read More

Mol Ther 2017 10 28;25(10):2415-2426. Epub 2017 Jul 28.

Institute of Infection, Immunity, and Inflammation, College of Medicine, Veterinary, and Life Sciences, University of Glasgow, Glasgow G12 8TA, UK. Electronic address:

Tendon injuries (tendinopathies) are common in human and equine athletes and characterized by dysregulated collagen matrix, resulting in tendon damage. We have previously demonstrated a functional role for microRNA29a (miR29a) as a post-transcriptional regulator of collagen 3 expression in murine and human tendon injury. Given the translational potential, we designed a randomized, blinded trial to evaluate the potential of a miR29a replacement therapy as a therapeutic option to treat tendinopathy in an equine model that closely mimics human disease. Read More

Vet Radiol Ultrasound 2017 Nov 6;58(6):671-678. Epub 2017 Jul 6.

Marion duPont Scott Equine Medical Center, Virginia-Maryland Regional College of Veterinary Medicine, Leesburg, VA, 24060.

Lesions of the distal deep digital flexor tendon (DDFT) are frequently diagnosed using MRI in horses with foot pain. Intralesional injection of biologic therapeutics shows promise in tendon healing; however, accurate injection of distal deep digital flexor tendon lesions within the hoof is difficult. The aim of this experimental study was to evaluate accuracy of a technique for injection of the deep digital flexor tendon within the hoof using MRI-guidance, which could be performed in standing patients. Read More

Stem Cell Res Ther 2017 06 5;8(1):129. Epub 2017 Jun 5.

Equine Clinic, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, 30559, Hannover, Germany.

Background: Adipose tissue is a promising source of mesenchymal stromal cells (MSCs) for the treatment of tendon disease. The goal of this study was to assess the effect of a single intralesional implantation of adipose tissue-derived mesenchymal stromal cells (AT-MSCs) on artificial lesions in equine superficial digital flexor tendons (SDFTs).

Methods: During this randomized, controlled, blinded experimental study, either autologous cultured AT-MSCs suspended in autologous inactivated serum (AT-MSC-serum) or autologous inactivated serum (serum) were injected intralesionally 2 weeks after surgical creation of centrally located SDFT lesions in both forelimbs of nine horses. Read More

J Comput Assist Tomogr 2017 Mar/Apr;41(2):336-338

From the *Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Center for Trauma Rehabilitation Research, Quentin Mease Hospital, Harris County Hospital District, Houston, TX; †Department of Neurology, University of Texas School of Medicine, Houston, TX; and ‡Veterans Affairs Mid-Atlantic (VISN 6) Mental Illness Research, Education, and Clinical Center, Research and Academic Affairs Service Line, W G Hefner Veterans Affairs Medical Center, Salisbury, NC.

Objectives: To provide musculoskeletal ultrasound (MSKUS) images of hand anatomy in the position of hemiparetic flexion as a reference for spasticity injections. After a stroke, spasticity can result in anatomic distortion of the hand. Spasticity may require treatment with botulinum toxin or phenol injections. Read More

Equine Vet J 2017 Sep 28;49(5):655-661. Epub 2017 Feb 28.

Pole Equin, VetAgro Sup, Marcy L'Étoile, France.

Background: Navicular disease in the horse often requires injection of the navicular bursa. We have developed an ultrasound-guided, lateral needle approach to navicular bursocentesis, which avoids penetration of the deep digital flexor tendon (DDFT) and the need for radiographic control.

Objectives: To describe and evaluate the feasibility and efficacy of an ultrasound-guided, lateral bursocentesis technique. Read More

J Hand Surg Am 2017 Feb 10;42(2):e119-e123. Epub 2016 Dec 10.

Division of Plastic Surgery, Vancouver General Hospital, University of British Columbia, Vancouver, Canada.

The literature generally supports the safety of epinephrine injection in the digits, but recent case reports describe ischemic adverse events associated with the use of lidocaine and epinephrine in which phentolamine rescue was not performed. We present a case of finger necrosis and subsequent amputation in a patient after 1% lidocaine with 1:100,000 epinephrine was injected in the fat and flexor sheaths in the palm for a 3-finger trigger release. Phentolamine rescue was not performed. Read More

Stem Cells Int 2016 26;2016:8610964. Epub 2016 Sep 26.

Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA.

Ultrasound-guided intralesional injection of mesenchymal stem cells (MSCs) is held as the benchmark for cell delivery in tendonitis. The primary objective of this study was to investigate the immediate cell distribution following intralesional injection of MSCs. Unilateral superficial digital flexor tendon (SDFT) lesions were created in the forelimb of six horses and injected with 10 × 10 MSCs labeled with superparamagnetic iron oxide nanoparticles (SPIOs) under ultrasound guidance. Read More

BMC Vet Res 2016 Sep 7;12(1):191. Epub 2016 Sep 7.

Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, 30559, Hannover, Germany.

Background: Regenerative and anti-inflammatory effects on tendinopathies have been attributed to blood-derived biologicals. To date the evidence for the efficacy of autologous platelet-rich plasma (PRP) treatment of naturally occurring equine tendinopathies is limited. The purpose of this placebo-controlled clinical trial was to describe the effect of a single treatment of equine superficial digital flexor tendon (SDFT) disease with PRP on clinical and ultrasonographic parameters. Read More

Cell Transplant 2016 12 7;25(12):2199-2211. Epub 2016 Jul 7.

Tendon disease has been treated with multipotent mesenchymal stromal cells (MSCs) in the equine large-animal model with promising success. The aim of this study was to gain more insight into the fate and biodistribution of MSCs after local application into tendon lesions by long-term cell tracking in this large-animal model. Superficial digital flexor tendon lesions were induced in all limbs in six horses and injected with 10106 Molday ION Rhodamine B-labeled MSCs suspended in serum or serum alone. Read More

Vet Res Forum 2016 15;7(1):21-6. Epub 2016 Mar 15.

Neurophysiology Research Center, Urmia University of Medical Sciences, Urmia, Iran.

Tendon never restores the complete biological and mechanical properties after healing. Several techniques are available for tissue-engineered biological augmentation for tendon healing like stem cells. Recently, synovium has been investigated as a source of cells for tissue engineering. Read More

Vet Rec 2016 Jul 20;179(3):69. Epub 2016 May 20.

Victorian Equine Group, Bendigo Equine Hospital, Victoria, Australia.

To evaluate a treatment protocol whereby superficial digital flexor (SDF) tendonitis in Thoroughbred and Standardbred racehorses was treated with autologous bone marrow aspirate (ABMA) obtained from the sternebrae. This treatment was combined with desmotomy of the accessory ligament of the SDF tendon (DAL-SDFT) in selected cases. Medical records of 105 horses treated using the reported protocol were reviewed. Read More

J Orthop Res 2016 12 7;34(12):2162-2171. Epub 2016 Apr 7.

Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, 1008 W Hazelwood Drive, Urbana, Illinois, 61802.

Tendinitis is a common and a performance-limiting injury in athletes. This study describes the value of intralesional tendon-derived progenitor cell (TDPC) injections in equine flexor tendinitis. Collagenase-induced tendinitis was created in both front superficial digital flexor (SDF) tendons. Read More

Stem Cell Res Ther 2016 Feb 1;7:21. Epub 2016 Feb 1.

Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, 30559, Hannover, Germany.

Background: Adipose tissue-derived mesenchymal stromal cells (AT-MSCs) are frequently used to treat equine tendinopathies. Up to now, knowledge about the fate of autologous AT-MSCs after intralesional injection into equine superficial digital flexor tendons (SDFTs) is very limited. The purpose of this study was to monitor the presence of intralesionally injected autologous AT-MSCs labelled with superparamagnetic iron oxide (SPIO) nanoparticles and green fluorescent protein (GFP) over a staggered period of 3 to 9 weeks with standing magnetic resonance imaging (MRI) and histology. Read More

J Orthop Surg (Hong Kong) 2015 Dec;23(3):345-8

Department of Orthopaedic Surgery, Maulana Azad Medical College & Associated Lok Nayak Hospital, New Delhi, India.

Purpose: To evaluate the outcome after single tendon transfer of the flexor carpi ulnaris (FCU) to the digital extensors for high radial nerve palsy.

Methods: Records of 10 patients aged 16 to 43 (median, 27) years who underwent single tendon transfer of the FCU to the digital extensors for high radial nerve palsy secondary to closed (n=4) or open (n=4) diaphyseal humeral fractures or deltoid injection (n=2) were reviewed. Two of the patients with open fractures also underwent treatment for non-union in a staged manner. Read More

Stem Cell Res Ther 2015 Nov 26;6:231. Epub 2015 Nov 26.

Department of Large Animal Clinical Sciences, Texas A&M University, College Station, TX, 77843, USA.

Introduction: Equine superficial digital flexor tendon injury is a well-accepted model of human tendon injury and is routinely treated with local injections of autologous mesenchymal stem cells (MSCs). Identification of a clinically safe medium for short-term cryopreservation of MSCs prior to cell implantation would streamline laboratory and clinical procedures for autologous regenerative therapies. Veterinary experience with short-term (MSCs prepared after the injury has occurred) cryopreserved MSCs in naturally occurring injury in the horse will be of value to human practitioners. Read More

J Am Vet Med Assoc 2015 Dec;247(11):1309-18

Objective: To describe the location and severity of deep digital flexor tendon (DDFT) lesions diagnosed by means of high-field-strength MRI in horses and to identify variables associated with return to activity following medical treatment.

Design: Retrospective case series.

Animals: 118 horses. Read More

Plast Reconstr Surg 2015 Sep;136(3):531-40

Cleveland, Ohio; and Louisville, Ky. From the Plastic Surgery Department, Cleveland Clinic; the Christine M. Kleinert Institute, University of Louisville; and the Radiology Department, Jewish Hospital and St. Mary's Health Care.

Background: Amputation of all fingers (metacarpal hand) can be functionally equivalent to hand amputation. Multidigit allotransplantation can benefit patients who require a full complement of fingers to return to their preinjury activities. The authors investigated the feasibility of the transfer of four fingers and thumb as a single allograft. Read More

Vet Med Int 2015 22;2015:903169. Epub 2015 Jun 22.

Sezione di Cliniche Veterinarie e P.A., Dipartimento delle Emergenze e Trapianti di Organo, Università degli Studi di Bari "Aldo Moro", s.p. per Casamassima km 3, Valenzano, 70010 Bari, Italy.

Aim of this study was to document the normal computed tomographic tenography findings of digital flexor tendon sheath. Six ex vivo normal equine forelimbs were used. An axial approach was used to inject 185 mg/mL of iopamidol in a total volume of 60 mL into the digital flexor tendon sheaths. Read More

Stem Cell Res Ther 2015 Jun 26;6:126. Epub 2015 Jun 26.

Equine Clinic, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, 30559, Hannover, Germany.

Introduction: Autologous blood-derived biologicals, including autologous conditioned serum (ACS), are frequently used to treat tendinopathies in horses despite limited evidence for their efficacy. The purpose of this study was to describe the effect of a single intralesional injection of ACS in naturally occurring tendinopathies of the equine superficial digital flexor tendon (SDFT) on clinical, ultrasonographic, and histological parameters.

Methods: Fifteen horses with 17 naturally occurring tendinopathies of forelimb SDFTs were examined clinically and ultrasonographically (day 0). Read More

Hand Clin 2015 May;31(2):345-54

Department of Orthopedics, Harvard Medical School, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, ST 10, Boston, MA 02215, USA. Electronic address:

This evidence-based article discusses the current management options of Dupuytren disease and strategies to avoid and manage any potential complications. Treatment options include fasciectomy, needle fasciotomy/aponeurotomy, and collagenase injection. Complications include digital nerve and artery injury, flexor tendon injury, skin fissures and wound healing complications, hematoma, infection, flare reaction/complex regional pain syndrome, and recurrence. Read More

Equine Vet J 2016 May 23;48(3):326-30. Epub 2015 May 23.

Department of Surgery and Anaesthesiology of Domestic Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.

Reasons For Performing Study: Controversy exists about the specificity of diagnostic analgesia of the digital flexor tendon sheath (DFTS) in horses.

Objectives: To evaluate the degree of diffusion of mepivacaine from the equine DFTS to adjacent synovial structures.

Study Design: Crossover experiment. Read More

Am J Phys Med Rehabil 2015 Apr;94(4):e26-30

From the Department of Rehabilitation Medicine, The Catholic University of Korea, Seoul St Mary's Hospital, Seoul, South Korea.

Trigger finger, or digital stenosing tenosynovitis, is a common hand problem. A widely accepted treatment is steroid injection into the flexor tendon sheath. This can cause rupture of the flexor tendon. Read More

Equine Vet J 2016 Mar 25;48(2):159-64. Epub 2015 Feb 25.

Clinical Sciences Department, Colorado State University, Fort Collins, USA.

Reasons For Performing Study: Injection of the navicular bursa is commonly performed from the palmar aspect of the limb, which results in penetration of the deep digital flexor tendon (DDFT).

Objectives: To report a radiographic guided injection from the lateral aspect of the limb that avoids puncture of the DDFT and to assess synovial and soft tissue penetration by the needle.

Study Design: Prospective clinical and cadaveric study. Read More

Acta Vet Scand 2014 Nov 25;56:78. Epub 2014 Nov 25.

Dipartimento di Science Veterinarie, Università degli Studi di Torino, via Leonardo da Vinci 44, Grugliasco, 10095, TO, Italy.

Background: Longitudinal tears in the lateral aspect of the deep digital flexor tendon are the most common causes of pain localised to the equine digital flexor tendon sheath. However conventional ultrasonographic techniques provide limited information about acute lesions. Ultrasonographic contrast agents are newly developed materials that have contributed to advancement in human diagnostic imaging. Read More

J Hand Surg Am 2014 Apr 5;39(4):744-751.e5. Epub 2014 Mar 5.

Department of Surgery (MMC), Monash University, Melbourne, Australia.

Purpose: To evaluate the time to onset of anesthesia, duration of anesthesia, and pain on injection of local anesthetics.

Methods: A systematic search of the English literature was performed of the Medline, Cochrane Central Register of Controlled Trials, The Allied and Complementary Medicine Database (AMED), and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. The study selection process was adapted from the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement, and 6 articles were complied with the study inclusion criteria. Read More

Hand (N Y) 2013 Dec;8(4):439-44

Division of Hand Surgery, Department of Orthopaedic Surgery, The Johns Hopkins University, 601 N. Caroline Street, Baltimore, MD 21287 USA ; c/o Elaine P. Henze, BJ, ELS, Medical Editor and Director, Editorial Services, Department of Orthopaedic Surgery, The Johns Hopkins University/Johns Hopkins Bayview Medical Center, 4940 Eastern Ave., #A665, Baltimore, MD 21224-2780 USA.

Background: Stenosing flexor tenosynovitis of the digital flexor tendon (trigger digit) is a common condition encountered by hand surgeons. Our purpose was to determine the efficacy of corticosteroid injections and review the demographic profile of patients with trigger digits.

Methods: We reviewed the records of 362 patients (577 trigger digits) treated with steroid injections (8 mg of triamcinolone acetonide in 1 % lidocaine) from 1998 through 2011. Read More

Vet J 2013 Dec 27;198 Suppl 1:e147-51. Epub 2013 Sep 27.

Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 112-114, 3584 CM Utrecht, The Netherlands.

Therapeutic reduction of the activity of the deep digital flexor (DDF) muscle may play a role in treatment of laminitic horses. Clostridium botulinum toxin type A induces reduced muscle activity and has a spasmolytic effect in horses. In this study, the effectiveness of 200 IU C. Read More

Vet J 2013 Dec 26;198 Suppl 1:e152-6. Epub 2013 Sep 26.

Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 114, 3584 CM Utrecht, The Netherlands; Department of Surgery and Anaesthesiology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium.

In the treatment of laminitis, reducing deep digital flexor muscle (DDFM) activity might diminish its pull on the distal phalanx, thereby preventing displacement and providing pain relief. Injection of Clostridium botulinum toxin type A into the DDFM of horses is potentially therapeutic. However, the effects of C. Read More

Plast Reconstr Surg 2013 Dec;132(6):977e-84e

Stanford, Calif.; and Seattle, Wash. From the Division of Plastic Surgery, Department of Surgery, and the Robert A. Chase Center for Hand and Upper Limb, Stanford University Hospital; and the Department of Orthopedic Surgery and the Division of Plastic Surgery, Department of Surgery, University of Washington Medical Center.

Background: This study was designed to establish the essential hand surgery procedures that should be mastered by graduating plastic surgery residents. This framework can then be used as a guideline for developing Objective Structured Assessment of Technical Skill to teach technical skills in hand surgery.

Methods: Ten expert hand surgeons were surveyed regarding the essential hand surgery procedures that should be mastered by graduating plastic surgery residents. Read More

PLoS One 2013 25;8(9):e75697. Epub 2013 Sep 25.

Department of Clinical Sciences and Services, the Royal Veterinary College, University of London, Hatfield, United Kingdom.

Tendon injuries are a common age-related degenerative condition where current treatment strategies fail to restore functionality and normal quality of life. This disease also occurs naturally in horses, with many similarities to human tendinopathy making it an ideal large animal model for human disease. Regenerative approaches are increasingly used to improve outcome involving mesenchymal stem cells (MSCs), supported by clinical data where injection of autologous bone marrow derived MSCs (BM-MSCs) suspended in marrow supernatant into injured tendons has halved the re-injury rate in racehorses. Read More

Vet Res Forum 2013 ;4(4):233-8

Department of Clinical Sciences, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran;

Tendons are frequently targets of injury in sports and work. Whether nonsteroidal anti-inflammatory drugs (NSAIDs) have beneficial effects on tendon healing is still a matter of debate. This study was conducted to evaluate effects of flunixin meglumine (FM) on tendon healing after experimentally induced acute trauma. Read More

Equine Vet J 2014 Jul 21;46(4):488-93. Epub 2013 Nov 21.

Department of Surgery and Anaesthesiology of Domestic Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.

Reasons For Performing Study: Controversy exists about the desensitisation obtained after diagnostic analgesia of the digital flexor tendon sheath (DFTS) during lameness examinations.

Objectives: To determine whether DFTS analgesia results in inadvertent desensitisation of the palmar/plantar digital nerves and whether this depends on the injection technique used.

Study Design: Crossover experimental study. Read More

J Am Vet Med Assoc 2013 Sep;243(6):869-73

Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, MS 39762, USA.

Objective: To define a method for the basilar sesamoidean approach (BSA) to the digital flexor tendon sheath (DFTS) in horses and compare it with the axial sesamoidean approach (ASA) for DFTS synoviocentesis and injection.

Design: Evaluation study.

Animals: 12 healthy adult mares without evidence of abnormalities related to the lower limbs. Read More

J Am Acad Orthop Surg 2013 Aug;21(8):443-7

Department of Plastic and Reconstructive Surgery, Dalhousie University, Saint John, New Brunswick, Canada.

Traditionally, surgeons were taught that local anesthesia containing epinephrine should not be injected into fingers. This idea has since been refuted in many basic and clinical scientific studies, and today, injection of lidocaine plus epinephrine is widely used for digital and hand anesthesia in Canada. The key advantages of the wide-awake technique include the creation of a bloodless field without the use of an arm tourniquet, which in turn reduces the need for conscious sedation. Read More

Anat Rec (Hoboken) 2013 Aug 17;296(8):1187-95. Epub 2013 Jun 17.

Department of Structural and Functional Biology, Institute of Biology, UNICAMP, SP, Brazil.

Tendinopathy is a pathology found mainly in the rotator cuff, patellar, Achilles and flexor tendons. Tendinopathy is a significant impediment to performance in athletes and in workers in the labor market. Some studies have indicated that inflammation in adjacent tissues may affect the rotator cuff and Achilles tendon. Read More