Revolutionary Tendon Repair Device for Hands and WristsPublished: Feb 23, 2023
By Tampa General Hospital
One of the biggest challenges associated with repairing hand and wrist tendons is the stiffness and scarring that can result from the surgery. For this reason, protocols call for early active rehabilitation, which shortens immobilization time and improves healing. At Florida Orthopedic Institute (FOI), a new device is making that protocol possible.
The CoNextions® TR Tendon Repair System provides a stronger, faster, and lower profile alternative to traditional suture repair techniques for flexor and extensor tendons in the hand, wrist, and forearm. It facilitates repairs that are two times stronger, over three times faster, and offer smoother tendon gliding than with sutures.
FOI surgeons, Dr. Michael Garcia and Dr. Alfred Hess have been using the device to perform hand and wrist tendon repairs for the past year.
“When I saw how simple, fast and strong the device is, it impressed me,” said Dr. Garcia. “It has become my go-to tendon repair device.”
Dr. Hess agrees. “This device is a game changer. The speed and strength of repair allows our hand surgeons to concentrate on other more technical aspects of hand trauma,” he said.
FOI is among few medical centers in the country where the CoNextions® device is used in such high volume. The results have been extremely positive, and Drs. Garcia and Hess plan to publish definitive results in the coming months.
TREATING HANDS AND WRISTS
Hand & Wrist surgery at Tampa General Hospital (TGH) is performed by fellowship trained surgeons from the Florida Orthopaedic Institute Hand & Wrist Service Division. They treat injuries to bones, ligaments, nerves, and arthritic joints, as well as perform reconstruction surgery, free tissue transfers, and limb replantation. Our surgical team has the highest level of achievement in this discipline by holding board certification in orthopedic surgery, fellowship training, and a certificate of added qualifications (CAQ) in hand surgery. FOI has managed the Upper Extremity Fracture and Trauma Service at TGH for over 25 years. As active researchers, teachers, and educators, these surgeons train residents, fellows, and other orthopedic surgeons through their lectures, courses, and ongoing publications.
The Hand & Wrist Service Division provides care to thousands of patients each year through busy clinical practices and referrals from TGH. They specialize in acute care of the injured limb and post traumatic reconstruction of salvaged and amputated limbs, while providing longitudinal care that begins in the emergency room and lasts throughout a patient’s recovery. The hand and wrist service act as the primary referral center for the majority of upper extremity trauma for a large portion of the state of Florida. In order to better serve our trauma patients, FOI started the Reconstructive Limb Loss Clinic in 2019 by coordinating with local and regional prosthetists. Utilizing the most advanced myoelectric prostheses available, physical therapists, occupational therapists, pain management specialists, and psychologists comprise our multidisciplinary approach to healing upper extremity pathology.
The Upper Extremity Fracture Service treats Level I injuries to bones, ligaments, tendons, nerves, and joints sustained in car, boat, motorcycle, motor vehicle, and work-related accidents, including amputations of the upper extremity from the shoulder to the fingertips, infections, and crush injuries. Our surgeons excel in microvascular surgery due to their extensive experience in the replantation of the upper extremity.
TARGETED MUSCLE REINNERVATION (TMR)
Surgeons at FOI are fully trained to perform TMR in pediatric and adult cases. For the nearly two million Americans who have lost a limb, relearning how to perform simple tasks with a prosthesis takes time and patience. Alfred V. Hess, MD Director, Hand and Upper Extremity Service For many amputees, this can be virtually impossible due to constant phantom pain caused by severed nerves. TMR connects amputated nerves to nerve branches of a nearby muscle group, creating new connections and giving those previously disconnected signals somewhere to propagate. This procedure allows the nerves to regenerate in an organized fashion, which the brain perceives in a less painful way. When TMR is performed at the time of amputation, researchers found a marked reduction in neuroma formation and patient reported pain scores 6 months post-operative. In addition to TMR, our surgeons have extensive experience in nerve surgery for both acute and chronic injuries, ranging from the brachial plexus to the tips of the fingers. Techniques such as nerve grafting and nerve transfer are used to improve patient outcomes from these devastating problems.