Narrow Results

Lipoblastoma of the hand is a rare benign tumour of infancy. Although benign, the tumour can present as a large mass. We present a case of a two-year-old female with a large, slowly growing soft tissue mass between the second and third metacarpal of the right hand. After excision of the mass, the deep transverse metacarpal ligament (DTML) was reconstructed using a free tendon graft from the extensor indicis propius (EIP).

Background: Synthetic scaffold has been used for tissue approximation and reconstructing damaged and torn ligaments. This study explores the ability of tendon ingrowth into a synthetic scaffold in vitro, evaluate growth characteristics, morphology and deposition of collagen matrix into a synthetic scaffold.

Methods: Upper limb tendons were harvested with consent from patients with crush injuries and non-replantable amputations. These tendons (both extensor and flexor) measuring 1 cm are sutured to either side of a 0.5 cm synthetic tendon strip and cultured in growth medium. At 2, 4, 6 and 8 weeks, samples were fixed into paraffin blocks, cut and stained with haematoxylin-eosin (H&E) and Masson’s trichrome.

Results: Minimal tendon ingrowth were seen in the first 2 weeks of incubation. However at 4 weeks, the cell ingrowth were seen migrating towards the junction between the tendon and the synthetic scaffold. This ingrowth continued to expand at 6 weeks and up to 8 weeks. At this point, the demarcation between human tendon and synthetic scaffold was indistinct.

Conclusions: We conclude that tendon ingrowth composed of collagen matrix were able to proliferate into a synthetic scaffold in vitro.

A 39-year-old man injured his left little finger and was diagnosed with chronic tendon mallet with -50° of extension and 80° of flexion at the DIP joint. We performed an anatomical reconstruction of the terminal tendon and both lateral bands with divided palmaris longus tendon grafting. Postoperative range of motion at the DIP joint improved to -5° of extension with no flexion loss. We demonstrated a novel surgical technique for chronic tendon mallet injury that might represent a useful choice for the treatment of chronic mallet finger injury.