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14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Designing a minimally-invasive, ultrasound-guided, percutaneous technique of washout of the flexor tendon sheath: an anatomical study

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  • presenting/speaker Philippe Liverneaux - Strasbourg University Hospital, Strasbourg, France
  • Etienne Boyer - Strasbourg University Hospital, Strasbourg, France

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-161

doi: 10.3205/19ifssh0165, urn:nbn:de:0183-19ifssh01654

Published: February 6, 2020

© 2020 Liverneaux et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives/Interrogation: The goal of this study was to develop a minimally-invasive, ultrasound-guided technique of percutaneous washout of flexor tendon sheath on an anatomical model.

Methods: Two catheters were inserted using ultrasound guidance at the proximal and distal ends of the tendon sheath of 20 fingers of cadaveric forearms. A percutaneous injection of saline solution colored with methylene blue enabled an anterograde washout of the flexor tendon sheath.

Results and Conclusions: The technique was successful in 13 out of 20 cases. The proximal catheter was in the right position in 17 cases and in 15 cases for the distal catheter. The flexor tendons were uninterrupted in all cases and bore puncture wounds in 9 cases.

Our results showed that this minimally-invasive, ultrasound-guided technique of percutaneous washout of the flexor tendon sheath was efficient in 65% of cases and safe in 100% of cases. In case of failure of the technique it is always possible to switch to a conventional open technique.