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Purpose: Adhesion formation is the major complication after tendon repairs that halts functional restoration and causes disability in patients. This study aimed to compare the antiadhesion efficacy of two tendon protector sheets using a previously established turkey flexor tendon model., Methods: Twenty-four adult Bourbon Red turkeys were randomized into three groups: (1) control, (2) type I collagen-glycosaminoglycan (Collagen-GAG), and (3) hyaluronic acid. In each group, the flexor digitorum profundus tendon of the middle digit was sharply lacerated at the proximal interphalangeal joint level. All operated feet were immobilized until sacrifice 6 weeks after the surgery. After sacrifice, the repaired and normal digits were collected for biomechanical testing, adhesion scores, histological examination, and adhesion-related gene expression analysis., Results: At 42 days after tendon repair, the normalized work of flexion of the repaired digit was the lowest in the Collagen-GAG group. The Collagen-GAG group also had the lowest gross adhesion score, indicating minimal adhesion. The hyaluronic acid group showed lower adhesion scores compared with the control, but the difference was not statistically significant. Microscopically, the Collagen-GAG group had a significantly lower histological adhesion score than the control group. In the Collagen-GAG group, the gene expression levels of WNT3A, WNT5A, and WNT7A were suppressed., Conclusions: In an avian model of flexor tendon repair, the application of tendon protector sheets reduces peritendinous fibrotic tissue formation histologically., Clinical Relevance: There are currently limited commercially available products to reduce postoperative peritendinous adhesions. Further validation is needed to confirm the effectiveness of tendon protector sheets in improving surgical outcomes following tendon repairs., Competing Interests: Conflicts of Interest Versawrap used in this study was provided by the company Alafair Biosciences. No benefits in any other form have been received or will be received related directly to this article., (Copyright © 2024 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.)

Purpose: To assess the effect of radial longitudinal deficiency on the function of pollicized digits as determined by the Thumb Grasp and Pinch (T-GAP) assessment., Methods: We retrospectively evaluated 25 hands with thumb hypoplasia that underwent index finger pollicization. Patients were followed for an average of 10.4 years. Hands were divided by severity into two groups: no or mild radial longitudinal deficiency (RLD) (Group 1 = 16) and moderate to severe RLD (Group 2 = 9). We collected demographic information and completed physical examination measures, including hand strength, elbow, wrist, and hand range of motion, the Kapandji opposition score, active grasp span, and T-GAP total score., Results: Patients with moderate to severe forms of RLD had stiffer long fingers, lower Kapandji opposition scores, and limited active and passive range of motion for elbow flexion, wrist ulnar deviation, and pollicized thumb interphalangeal flexion. They had shorter forearms, decreased active grasp span, and fewer thumb creases at the interphalangeal thumb joint. In addition, the T-GAP total score was significantly lower when comparing the two groups. Children with mild dysplasia were able to achieve 32% of age-matched normal grasp strength. Patients with more severe radial dysplasia averaged 17% less grasp strength compared with children with mild dysplasia. Patients with moderate to severe RLD also had lower T-GAP total scores and strength measurements if they had limited wrist ulnar deviation., Conclusions: Individuals with moderate to severe RLD have unique anatomical factors that affect outcomes after pollicization. These individuals use their thumbs for fewer activities, have weaker grasp, and retain more primitive grasp patterns compared with those who have milder forms of RLD., Type of Study/level of Evidence: Prognostic IV., Competing Interests: Conflicts of Interest No benefits in any form have been received or will be received related directly to this article., (Copyright © 2024 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.)

Congenital pancreatic cysts (CPCs) are rare developmental anomalies that arise in-utero from the pancreas. They are exceedingly rare in the literature, and most are discovered postnatally. Prenatal diagnosis is uncommon with only 21 published reports of prenatally diagnosed CPCs in the literature. CPCs may form unilocular or multilocular macrocysts which can distort normal anatomy. There is considerable overlap of imaging features with other macrocystic lesions of the neonatal abdomen. Ultrasound-guided biopsy and analysis of cyst aspirate for pancreatic enzymes may assist with obtaining an accurate preoperative diagnosis. We report a case of a 37-week gestational age female infant born with a known prenatal 9.5 cm macrocystic intrabdominal mass. An intrabdominal lymphatic malformation was initially diagnosed based on clinical and imaging features. Since conservative therapy with with cyst drainage and serial sclerotherapy was not effective, an ultrasound-guided biopsy was performed to rule out malignancy. Pancreatic tissue was identified on pathology. An exploratory laparotomy and total cystectomy was performed which confirmed the diagnosis of congenital pancreatic cyst originating from the pancreatic tail. This case highlights the diagnostic challenge of congenital pancreatic cysts and the importance of a multimodal and multidisciplinary diagnostic approach., (© 2022 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)