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    Effects of a Single Application of Adcon Gel on Peritendinous Adhesion: An Experimental Study in Rabbits
    (Journal Hard Tissue Biology, 2014) Ozden, Raif; Uruc, Vedat; Duman, Ibrahim Gokhan; Dogramaci, Yunus; Kalaci, Aydiner; Komurcu, Erkam; Ozsoy, Sule Yurdagul
    Peritendinous adhesions are serious complications after surgical repair of tendons and can lead to poor functional outcome. In the present study, the tensile strength of repaired tendons was measured biomechanically in two groups using a rabbit Achilles tendon model, and the effects of Adcon gel on peritendinous adhesions and tendon healing were examined by means of histological and mechanical analyses. In the treatment group, the Achilles tendon was transected, followed by a primary repair using a modified Kessler technique, and Adcon gel was injected between the tendon and skin of the right leg. The same operation was done for the control group, and 1 mL of normal saline solution was applied locally in a similar fashion. The experimental protocols were approved by the local animal ethics committee. Microscopic evidence of the formation of adhesions and of inflammation was less in the treatment group than in the control group. There was no significant difference in the tensile load necessary to rupture the repaired tendons between the two groups. Adcon gel reduced the peritendinous adhesions histologically without impairing tendon healing, as determined with mechanical analyses. The use of Adcon gel may provide a simple means of preventing of postoperative peritendinous adhesions, thereby offering a beneficial effect on tendon repair.
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    Spontaneous atraumatic extensor pollicis longus rupture in healthy individuals due to steroid injection: Two case reports
    (Medi+World Int, 2014) Ozden, Raif; Uruc, Vedat; Duman, Ibrahim Gokhan; Dogramaci, Yunus; Kalaci, Aydiner; Komurcu, Erkam
    Introduction: Local steroid injection is believed to be associated with risk of spontaneous tendon rupture. Spontaneous rupture of the extensor pollicis longus (EPL) tendon at the wrist is infrequent and essentially described after fracture of the distal radius. Rough bone ends, rheumatoid arthritis, lupus erythematosus, synovitis or tenosynovitis both contribute to this process. The aim of this study is to define rupture of the EPL tendon with review of the literature in two cases after receiving local steroid injections. Case presentation: The operative records for two patients undergoing EPL reconstruction by an author were criticized. All 2 patients had exposure to local steroids but this exposure was not into the ruptured tendon. It is administered about 2 cm away from the tendon. We identified 2 patients who presented with spontaneous EPL tendon rupture owing to steroid injection. These patients reported no risk factors or inciting event other than steroid injection. EPL were operatively repaired in two cases. At the 2-year follow-up, patients could completely extend the thumb. The cases were from the Eastern Mediterranean region of Turkey. Conclusion: In patients with unexpected loss of extension of the thumb interphalangeal joint, with a history of steroid injection, rupture of EPL tendon should be considered even if it was administered to remote location.