Jin Bo Tang's research while affiliated with Nantong University and other places

Publications (228)

Article
Lacerated flexor tendons close to bony junction are commonly repaired using a pullout suture. However, these injuries very close to the tendon-bone junction can be repaired with robust direct suture repair of the proximal tendon stump with the short residual tendon stump and any local tissues such as periosteum and joint volar plate. Subacute or ch...
Article
I have put together 10 topics and labeled them as hypotheses, which outline my preferred practices. The topics relate to questionable nerve compression, double crush syndrome of nerves, motion therapy after surgery, delayed primary tendon repair, proximal pole fracture of the scaphoid, short splint, and indications for postoperative hand elevation....
Article
This article discusses ulnar, median, and radial nerve compression in the proximal forearm and elbow and some possible common misconceptions. In particular, the ligament of Struthers extremely rarely causes ulnar neuropathy. Lacertus syndrome and flexor superficialis-pronator syndrome can be diagnosed separately. Surgical release can be through a s...
Article
We investigated the influence of cyclooxygenase (COX)-1 and COX-2 siRNAs delivered through a nanoparticle-gel system on the strength of flexor tendon repairs. Sixteen flexor digitorum profundus (FDP) tendons of chicken toes were transected, repaired and wrapped with gels to evaluate gel adherence. We found that the gel adhered to the tendon surface...
Article
In this article, I review how my team and I addressed clinical concerns in Zone 2 flexor tendon repair, and how major findings in each step of our research were translated into clinical practice. The focus of the article is on the thought processes behind each new investigation, the interpretation of research findings and conclusions drawn from the...
Chapter
The lacerated flexor tendons should be repaired in the first days or weeks after injury. The tendon should be repaired directly with a strong suture method, proper venting of the critical pulleys, and slight tension over the suture strands. The tendon should be tested immediately after the repair to confirm no gapping at the repair site during digi...
Article
This article summarizes the current views and proposed approaches to treating soft tissue defects of the hand. The article also outlines some key considerations of digital reconstruction. There are many options in treating soft tissue defects. For defects of the hand, local flaps are primarily considered if the defects are small or moderate in size...
Article
Full-text available
The current clinical methods of flexor tendon repair are remarkably different from those used 20 years ago. This article starts with a review of the current methods, followed by presentation of past experience and current status of six eminent hand surgery units from four continents/regions. Many units are using, or are moving toward using, the rec...
Article
Poor healing ability and adhesion formation greatly hinder the recovery of injured tendon function. Previously, our local sustained gene delivery system by using cyclooxygenases (COX-1 and COX-2)-engineered miRNA plasmid/nanoparticle loaded hydrogel significantly inhibited adhesion formation and promoted tendon healing. The present study aims to st...
Article
In this review I detail the protocol that I use after flexor tendon repair and outline my experience regarding how its framework might be used for other disorders. The early passive–active flexion protocol has a sufficient number of cycles of active flexion in each exercise session, which is at least 40, and ideally 60 to 80. The frequency of exerc...
Article
We assessed the effects of tendon core sutures' transverse components on the tensile resistance of two commonly used 6-strand tendon repairs. Tang and Yoshizu #1 repairs (6-strand) were tested and compared with 4-strand rectangular and double Kessler sutures (4-strand). A total of 40 pig flexor tendons were tested under cyclic loading. We recorded...
Article
We investigated the effects of the transverse components of a tendon core suture on tensile resistance and strength of 4-strand repairs. Forty-four pig flexor tendons were repaired with one of the following four methods: double Tsuge, U-shaped, 4-strand cross and 4-strand rectangular repairs. We recorded the number of the repaired tendons that form...
Chapter
Edited and authored by leading international experts, Distal Radius Fractures: Evidence-Based Management provides a state-of-the-art overview of diagnosis and management based on today’s best practices. Each chapter focuses on one key issue, offering a challenging case and then questioning the reader in an engaging fashion to provide the best avail...
Article
Tendon injuries are common diseases. The healing capacity of tendon is limited due to its special composition of extra-cellular matrix and hypocellularity and hypovascularity. The purpose of this study was to evaluate the effectiveness of nanoparticle-coated sutures carrying growth factors for accelerating tendon repair. A variety of experimental m...
Chapter
Tendon rupture after distal radius fractures were found with or without surgical treatment. The timing of the tendon rupture varies from days or months after fracture or many years after surgical treatment. The most common incidence is associated with open reduction and internal fixation when the plate is not placed in a correct position and most c...
Article
Novel and combined tissue transfers from the lower extremity provide new tools to combat soft tissue defects of the hand, foot, and ankle, or fracture nonunion. Flaps can be designed for special purposes, such as providing a gliding bed for a grafted or repaired tendon or for thumb or finger reconstruction. Propeller flaps can cover soft tissue def...
Article
Several methods can be used for identifying tissues for transfer in donor-site-depleted patients. A fillet flap can be temporarily stored in other parts of the body and transferred back to the site of tissue defect, including covering the amputated stump of the lower extremity. Human arm transplant is rare and has some unique concerns for the surge...
Article
Survival rates of digital replantation vary in different regions and countries, and Asian surgeons see more challenging cases and have developed some unique methods. Replantation of multiple digits in one or both hands can follow a structure-by-structure method or a digit-by-digit method. For replanting all 10 digits, 3 or 4 teams should be organiz...
Article
Vascularized small-bone grafting is an efficient and often necessary surgical approach for nonunion or necrosis of several bones in particular sites of the body, including scaphoid, lunate, distal ulna, and clavicle. The medial femoral condyle is an excellent graft source that can be used in treating scaphoid, ulna, clavicle, or lower-extremity bon...
Article
The tendon-to-bone healing after trauma is usually slow and weak, and the repair site is easily disrupted during early mobilization exercise. bFGF and VEGFA gene therapy may hold promise in augmenting the tendon-to-bone healing process through enhancing cell proliferation and angiogenesis. This study is conducted to determine the effects of nanopar...
Article
This article summarizes the major changes seen in lymphatic microsurgery and microvascular surgery in first 20 years of the 21st century. Lymphatic microsurgery is discussed first, as more advances have been seen in imaging of the lymphatic system, lymphatico-venous anastomosis, and vascularized lymph node transfers. During the past 2 decades, ther...
Article
Tendon stem/progenitor cells (TSPCs) are considered to be promising seed cells for tendon regeneration. Previous studies reported that a low seeding density favors TSPC growth, while a high seeding density favors tenocyte growth. We aimed to distinguish TSPCs from tenocytes by seeding tendon-derived cells at a density gradient. Here, tendon-derived...
Article
Full-text available
How to accelerate tendon healing remains a clinical challenge. In this study, a suture carrying nanoparticle/pEGFP-basic fibroblast growth factor (bFGF) and pEGFP-vascular endothelial growth factor A (VEGFA) complexes was developed to transfer the growth factor genes into injured tendon tissues to promote healing. Polydopamine-modified sutures can...
Article
The developments in flexor tendon repairs have remarkably changed the methods of surgical repair of the flexor tendons and treatment of the critical annular pulleys, as well as the postoperative active motion protocols. The article summarizes the current knowledge and clinical methods in treating flexor tendon injuries, the keys to achieving reliab...
Article
Current standard management of a cut digital nerve is end-to-end microsurgical nerve coaptation where possible. A recent systematic review of adult digital nerve injuries that were either repaired or left unrepaired showed that the evidence for good nerve recovery or improved function following nerve repair is poor. In the 30 studies included, only...
Article
The authors’ experience demonstrates that wide-awake flap surgery in the hand is safe. The authors used this approach in 4 commonly used flaps in the hand in 27 patients: the extended Segmuller flap, the homo-digital reverse digital artery flap, the dorsal metacarpal artery perforator flap, and the Atasoy advancement flap. Wide-awake flap surgery w...
Article
This article summarizes the application of local anesthesia no tourniquet in 2 hand surgery centers in China, Nantong and Tianjin, where more than 12,000 patients were operated on with the new approach. This approach achieves excellent anesthetic and vasoconstrictive effects. In Nantong, surgeons performed fracture fixation, soft tissue tumor excis...
Article
This article reviews the impact of wide-awake hand surgery without tourniquet on departmental settings and savings on patients’ medical cost, and efficiency of fellowship training and practice of junior hand surgeons in 3 units in 3 countries. The medical cost of the commonly performed procedures is decreased remarkably with this approach in the 3...
Article
We review recent developments in using occlusive dressings, dermal templates, and venous flaps for less invasive approaches to treat soft tissue defects of the forearm and fingers. Occlusive dressings can be used for thumb tip or fingertip trauma with soft tissue defects of small or moderate sizes. They permit skin regeneration without use of skin...
Article
This article reviews some recent advancements in repair and rehabilitation of the flexor tendons. These include placing sparse or no peripheral suture when the core suture is strong and sufficiently tensioned, allowing the repair site to be slightly bulky, aggressively releasing the pulleys (including the entire A2 pulley or both the A3 and A4 pull...
Article
New developments in primary tendon repair over the past decades include stronger core tendon repair techniques, judicious and adequate venting of critical pulleys, followed by a combination of passive and active digital flexion and extension. During repair, core sutures over the tendon should have sufficient suture purchase (no shorter than 0.7 to...
Article
Statement of significance: A local sustained gene delivery system was developed to regulate the expression of targeted genes in the specific time and location for tendon adhesion treatment. The engineered miRNA plasmid/nanoparticles embedded in hyaluronic acid hydrogel were synthesized to downregulate the expression of cyclooxygenases in the tendo...
Article
Purpose: To investigate the changes in length of the scapholunate interosseous ligament (SLIL) when the wrist is resisting horizontal lateral load and the forearm is in full pronation in vivo. Methods: We obtained computed tomography scans of the wrists of 6 volunteers in 3 situations: 0° position (0° extension and 0° ulnar inclination) and full...
Article
In this article, we present the experiences from Chinese microsurgeons on 5 less commonly used free vascularized flaps in hand reconstruction. In many units in China, these flaps have become the mainstays of treatment; they are routinely used for fingertip and thumb reconstruction. Their combined experience has demonstrated the reliability and vers...
Article
Common hand problems are treated differently in different countries. This article attempts to bring together the views of surgeons from different countries on some of the most common hand problems that hand surgeons encounter in daily practice. In practice, the correct treatment of these problems may be the most important and influential to patient...
Article
Over the past 2 decades, repair and rehabilitation methods of primary repair of the digital flexor tendon have changed. In this article, we outline interim results from ongoing investigations in several units. Surgeons in these units now perform digital flexor tendon repairs according to a treatment protocol. Before adopting the protocol, they had...
Article
In China, wide-awake surgeries are increasingly used by surgeons in a growing number of hospitals for hand and upper extremity surgeries. Experience suggests that wide-awake surgery is safe, economical, and patient-friendly, optimizing hospital resource allocation and increasing efficiency. This article discusses which procedures are most suitable,...
Article
Survival rates of digital replantation vary in different regions and countries, and Asian surgeons see more challenging cases and have developed some unique methods. Replantation of multiple digits in one or both hands can follow a structure-by-structure method or a digit-by-digit method. For replanting all 10 digits, 3 or 4 teams should be organiz...
Article
Several methods can be used for identifying tissues for transfer in donor-site-depleted patients. A fillet flap can be temporarily stored in other parts of the body and transferred back to the site of tissue defect, including covering the amputated stump of the lower extremity. Human arm transplant is rare and has some unique concerns for the surge...
Article
Novel and combined tissue transfers from the lower extremity provide new tools to combat soft tissue defects of the hand, foot, and ankle, or fracture nonunion. Flaps can be designed for special purposes, such as providing a gliding bed for a grafted or repaired tendon or for thumb or finger reconstruction. Propeller flaps can cover soft tissue def...
Article
Vascularized small-bone grafting is an efficient and often necessary surgical approach for nonunion or necrosis of several bones in particular sites of the body, including scaphoid, lunate, distal ulna, and clavicle. The medial femoral condyle is an excellent graft source that can be used in treating scaphoid, ulna, clavicle, or lower-extremity bon...
Article
Objective: Medial elbow incision is obligatory for cubital tunnel syndrome surgical treatment. However, the terminal branches of both the medial antebrachial cutaneous nerve (MACN) and the medial brachial cutaneous nerve (MBCN) are likely to be harmed using the current incision technique. The aim of this study was to seek a new incision to avoid da...
Article
Objective: To report the clinical and functional outcomes of our patients with complete divisions of flexor tendons in zone 2 using a 6-strand core M-Tang repair method and partial early active motion protocol and examines the possible factors affecting the functional outcomes. Materials and Methods: We conducted a retrospective review of all patie...
Article
Objectives: We report our experience in using a perforator island flap based on the middle dorsal branch of the proper palmar digital artery for repairing fingertip defect and analyze the clinical outcomes in 25 patients. Methods: Between January 2014 and July 2015, we repaired soft tissue defects of 25 fingers, including 10 index, 4 middle, 5 ring...
Article
Objective: To report outcomes of repair of flexor pollicis longus (FPL) tendon in 23 thumbs followed by early active thumb motion. Materials and Methods: We used a 6-strand repair with very loose epitenon suture for lacerated FPL tendons in 23 thumbs. These patients were treated between January 2014 and May 2015. All patients were repaired primaril...
Article
Full-text available
Purpose: The aim of the study was to determine the correlation of patterns of distal radius fractures with the triangular fibrocartilage complex (TFCC) injures. Methods: Sixty adult patients (mean age, 43 years) with distal radius fractures were included. The patients were analyzed according to the fracture character at the time of injury and class...
Article
Objective: Some inconsistencies can be observed among subjective satisfaction, objective functional results, and psychological sequelae. The aim of this follow-up study was to present the long-term comprehensive results of successful digit replantation and to analyze the relevance among subjective satisfaction, objective functional results, and psy...
Article
Purpose: A major challenge in repairing injured digital flexor tendon is the weak intrinsic healing capacity of tendon, which is responsible for rerupture of repaired tendon after primary repair. In an experimental model of transection and surgical repair of the digital flexor tendon in chicken toes, we aim to test the effectiveness of introducing...
Article
Objective: To report the results of an audit of repair of zone 2 flexor tendons in 68 digits using two different repair methods and rehabilitation protocols. Materials and Methods: From January 2014 to January 2015, we treated 35 digits in 21 consecutive patients who had complete divisions of flexor tendons in zone 2. All tendon repairs followed an...
Article
Full-text available
Tendon injury during limb motion is common. Damaged tendons heal poorly and frequently undergo unpredictable ruptures or impaired motion due to insufficient innate healing capacity. By basic fibroblast growth factor (bFGF) or vascular endothelial growth factor (VEGF) gene therapy via adeno-associated viral type-2 (AAV2) vector to produce supernorma...
Article
Introduction: Rupture of the repair and adhesion around a tendon are two major problems after tendon surgery. Novel biological therapies which enhance healing and reduce adhesions are goals of many investigations. Gene therapy offers a new and promising approach to tackle these difficult problems. In the past decade, we sought to develop methods t...
Article
Subject To describe techniques of venting major pulleys – A2 and A4 pulley during primary repair. Methods During primary repair of the zone II flexor tendon, major pulleys often present as an obstacle of passing the tendon and restrict tendon gliding. Those pulleys can be vented under following conditions: – other pulleys are intact; – tendon inju...

Citations

... As hand is one of the most frequently used extremity when manipulating machines, high rate of injury that caused by various injury mechanisms makes it more vulnerable [1,2]. Soft tissue defects of the hand require systematized methods to restore the function and aesthetic appearance [3,4]. As stable skin supply and soft tissue coverage are regarded as the primary goal during the reconstruction of mutilated hands, essential consideration on these aspects during surgical planning is getting more and more attention [5]. ...
... The calibre of suture utilized has traditionally been a 3/0, although 4/0 may be appropriate in more gracile tendons. (9,10). A bite of at least ten millimetres with each suture pass has been advocated (11), whilst an epitendinous suture [usually of 6/0 calibre] increases tensile strength and decreases bulk and gapping (9). ...
... COXs siRNA/nanoparticle loaded hydrogel Increase in M1 to M2 switch of macrophages and enhanced mechanical strength of repaired tendons Yang et al. (2022) Injectable hydrogel composed of BG and SA Increase in angiogenesis and M1 to M2 switch of macrophages. The injectable hydrogel reversed the pathological changes of injured tendons and enhanced the mechanical properties of repaired tendons Xu et al. (2022b) Tough hydrogels loaded with CORT Increase in cellularity and M2 macrophage polarization Freedman et al. (2022b) Hydrogel combined with celecoxib and Fe 3 O 4 nanoparticles Coordinated drug release of celecoxib under the stimulation of magnetic field. ...
... 8,14,15 Initially these regimens also involved a long dorsal-blocking splint, but more recent advances include a hand-based dorsal-blocking splint 16,17 and a finger-based relative motion flexion splint. 18,19 Flexor tendon rehabilitation protocols have been published in peer reviewed journals, 16,20 but there is currently no robust evidence to support the use of any particular early active rehabilitation regimen, 4 and anecdotally practice varies. The aim of this study was to describe rehabilitation guidelines being used in United Kingdom (UK) hand therapy departments for the management of adult patients following zone I and/or II flexor tendon repairs. ...
... Previous studies have reported that the transverse components of core sutures reduce the tensile strengths of two-, four-, and six-strand tendon repairs. [9][10][11] If different suture configurations are used during the same repair, ultimate repair strength is compromised by the noncumulative load, attributable to the dissimilar stiffnesses of the various repair components. 4 The Yoshizu cross-lock repair does not use a transverse core suture component; instead, there are two identical cross-locking passes. ...
... Previous studies have reported that the transverse components of core sutures reduce the tensile strengths of two-, four-, and six-strand tendon repairs. [9][10][11] If different suture configurations are used during the same repair, ultimate repair strength is compromised by the noncumulative load, attributable to the dissimilar stiffnesses of the various repair components. 4 The Yoshizu cross-lock repair does not use a transverse core suture component; instead, there are two identical cross-locking passes. ...
... Although the NPs system has been proved to restrain adhesion by loading TGF-β miRNA plasmid for weeks, and simplify the procedure by minimally invasive injection, the absence of rigid mechanical strength of these particles forbids them from acting as physical barriers to separate ruptured tendon from surrounding tissue and migrating inflammatory cells [24]. Similar obstacle was also faced by antiadhesion nanoparticle-coated suture, as no proper timberland could separate the extrinsic healing and cell invasion [145]. New insights of employing self-healing HA hydrogel with NPs entrapping antiadhesion molecules may be reliable solutions to avoid unexpected artificial physical barrier rupture during tendon gliding. ...
... Radial tunnel is a space in the proximal forearm, extending from the radiocapitellar joint to the distal margin of supinator muscle, bordered laterally by the brachioradialis, extensor carpi radialis brevis (ECRB) and longus muscles, and medially by the biceps and brachialis muscles. 2 The possible sites of radial nerve compression in this tunnel are; the capsular tissue of the radiocapitellar joint, leash of Henry (an arcade of branches of the recurrent radial artery), the fibrous edge of ECRB, the Frohse arcade (formed by the proximal border of superficial head of supinator muscle), and the distal edge of supinator muscle. 1 RTS presents with pain in the dorsolateral aspect of the proximal forearm. Sometimes sensory disturbances are also found along lateral aspect of the hand and distal forearm, without any motor weakness. ...
... In addition, poorly water-soluble active substances, such as curcumin, can use PNPs as nanocarriers to achieve sound transdermal properties Lin et al., 2017). Co-delivery based on PNPs has also received considerable attention Xing et al., 2020). Furthermore, their properties, such as particle radius and surface charge, can be controlled by adjusting the preparation method and the composition of PNPs and drugs, precisely controlling the loading effect, release kinetics, and stimuli-responsive release (Gao et al., 2020a;Hajialyani et al., 2018;Liu et al., 2020;Wu et al., 2022). ...
... Digit replantation is the complex technique of anastomosis on both artery and vein, arterial and venous obstruction can be detected during the operation via NIR-II imaging (Tang et al., 2020). But unlike simple vascular anastomosis, whether the replanted digit can survive or not also depends on sufficient arterial supply and compatible venous reflux. ...