514702 research-article2013
JHS0010.1177/1753193413514702Journal of Hand Surgery (European Volume)
JHS(E)
Editorial
The Journal of Hand Surgery (European Volume) 2014, Vol 39E(1) 5 © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/1753193413514702 jhs.sagepub.com
Special issue on Tendons It used to be thought that tendons were effectively dead tissue within the body, their only function being to transmit the contractive force of muscles to their bony insertions. Now we know that tendons contain cells, with some metabolic and reparative functions, and have a circulation, albeit sluggish. They are able to store elastic strain energy, acting as shock absorbers in protecting the body from injury. For the hand surgeon, it is essential to consider the tendons in relation to their surrounding tissues, particularly when the flexor tendons are injured within their sheaths. In this special issue of the Journal, experienced surgeons review the current state of knowledge about flexor tendon injuries and their repair. Intriguing glimpses into the future are given in articles on tissue engineering in relation to tendon replacement and the growth factors involved in tendon repair and adhesion formation. Modification of the healing process to prevent adhesions has always been the goal of surgeons; although improvements in surgical technique and post-operative management have gone some way towards this, the possibility of modifying the process at a cellular level is attractive. Hand surgeons are familiar with the concept that anatomy is variable, and must be prepared to identify anatomical anomalies. The flexor digitorum
superficialis brevis is one such anomaly that is not too infrequent. In this issue Bhat and colleagues review the many articles that have been written about it and revisit the concept that it represents a muscle that is seen in other species. This concept has been much debated over the years and I suspect the debate will continue. Can the possession of independent action of the flexor digitorum superficialis in the small finger affect one’s career? Godwin and her colleagues suggest that this may be the case in professional stringed instrument players. Perhaps this article will stimulate searches to find other examples in which a common anatomical variation in the hand may shape a person’s future. To round off the issue, members of the IFSSH Flexor Tendon Committee debate current issues. Their views are far from unanimous and therefore highlight areas where more research is needed to address practical problems. It is perhaps fitting that this special issue on tendons should be published soon after the passing of Harold Kleinert of Louisville in September 2013. Among his many contributions to hand surgery and the training of hand surgeons, he did so much to improve the management of flexor tendon injuries. Let this issue be a tribute in his memory.
Downloaded from jhs.sagepub.com at UCSF LIBRARY & CKM on March 23, 2015
Geoffrey Hooper Editor
JHS0010.1177/1753193413514702Journal of Hand Surgery (European Volume)
JHS(E)
Editorial
The Journal of Hand Surgery (European Volume) 2014, Vol 39E(1) 5 © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/1753193413514702 jhs.sagepub.com
Special issue on Tendons It used to be thought that tendons were effectively dead tissue within the body, their only function being to transmit the contractive force of muscles to their bony insertions. Now we know that tendons contain cells, with some metabolic and reparative functions, and have a circulation, albeit sluggish. They are able to store elastic strain energy, acting as shock absorbers in protecting the body from injury. For the hand surgeon, it is essential to consider the tendons in relation to their surrounding tissues, particularly when the flexor tendons are injured within their sheaths. In this special issue of the Journal, experienced surgeons review the current state of knowledge about flexor tendon injuries and their repair. Intriguing glimpses into the future are given in articles on tissue engineering in relation to tendon replacement and the growth factors involved in tendon repair and adhesion formation. Modification of the healing process to prevent adhesions has always been the goal of surgeons; although improvements in surgical technique and post-operative management have gone some way towards this, the possibility of modifying the process at a cellular level is attractive. Hand surgeons are familiar with the concept that anatomy is variable, and must be prepared to identify anatomical anomalies. The flexor digitorum
superficialis brevis is one such anomaly that is not too infrequent. In this issue Bhat and colleagues review the many articles that have been written about it and revisit the concept that it represents a muscle that is seen in other species. This concept has been much debated over the years and I suspect the debate will continue. Can the possession of independent action of the flexor digitorum superficialis in the small finger affect one’s career? Godwin and her colleagues suggest that this may be the case in professional stringed instrument players. Perhaps this article will stimulate searches to find other examples in which a common anatomical variation in the hand may shape a person’s future. To round off the issue, members of the IFSSH Flexor Tendon Committee debate current issues. Their views are far from unanimous and therefore highlight areas where more research is needed to address practical problems. It is perhaps fitting that this special issue on tendons should be published soon after the passing of Harold Kleinert of Louisville in September 2013. Among his many contributions to hand surgery and the training of hand surgeons, he did so much to improve the management of flexor tendon injuries. Let this issue be a tribute in his memory.
Downloaded from jhs.sagepub.com at UCSF LIBRARY & CKM on March 23, 2015
Geoffrey Hooper Editor
