title: Outcomes After Flexor Tendon Repair Combined With the Application of Human Amniotic Membrane Allograft.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Therapeutic V.
authors.affiliation: Department of Hand- and Microsurgery, University of Tampere, Tampere, Finland; School of Medicine, University of Tampere, Tampere, Finland. Electronic address: olli.v.leppanen@uta.fi.
authors.forename: Olli V
authors.initials: OV
authors.lastname: Leppänen
authors.affiliation: Department of Surgery, Central Hospital of Central Finland, Jyväskylä, Finland.
authors.forename: Teemu
authors.initials: T
authors.lastname: Karjalainen
authors.affiliation: Department of Hand- and Microsurgery, University of Tampere, Tampere, Finland.
authors.forename: Harry
authors.initials: H
authors.lastname: Göransson
authors.affiliation: Regea Cell and Tissue Center, BioMediTech, University of Tampere, Tampere, Finland.
authors.forename: Annika
authors.initials: A
authors.lastname: Hakamäki
authors.affiliation: Pohjola Hospital, Tampere, Finland.
authors.forename: Jouni
authors.initials: J
authors.lastname: Havulinna
authors.affiliation: Department of Pathology, Fimlab Laboratories, Tampere, Finland.
authors.forename: Jyrki
authors.initials: J
authors.lastname: Parkkinen
authors.affiliation: Department of Hand- and Microsurgery, University of Tampere, Tampere, Finland.
authors.forename: Jarkko
authors.initials: J
authors.lastname: Jokihaara
mesh_terms: D000328:Adult; D000368:Aged; D000650:Amnion / Q000637:transplantation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010865:Pilot Projects; D011446:Prospective Studies; D016059:Range of Motion, Articular; D013536:Suture Techniques; D013708:Tendon Injuries / Q000601:surgery*; D000267:Tissue Adhesions / Q000517:prevention & control; D016896:Treatment Outcome
keywords: Adhesion; finger; operation; stiffness; tendon injury