Comparison of surgical trends in zone 2 flexor tendon repair between Turkish and international surgeons

Ünsal, Seyyid Şerif; Yıldırım, Tuğrul; Armangil, Mehmet

doi:10.1016/j.aott.2019.07.003

Cited by 7 publications

(7 citation statements)

References 20 publications

(41 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Despite the efforts of several authors, no universally accepted treatment for flexor tendon injuries has evolved. Tendon surgery is to provide tendon healing with adequate tensile strength, adhesion reduction, proper tendon gliding and excursion [22]. Our Patients were treated with primary repair utilizing the 4-strand approach in this study.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Heparin Injection Into Cut Ends of Flexor Tendon Zone II Injuries

Gadallah

Elbarbary

Abdelsalam

et al. 2022

The Egyptian Journal of Plastic and Reconstructive Surgery

View full text Add to dashboard Cite

Background: Because the FDP (flexor digitorum profundus) and the two slips of the FDS (flexor digitorum superficialis) are crowded within a tight fibro-osseous tunnel, it has never been easy to have good functional results after flexor tendon restoration in zone II, elevating the possibility of postoperative adhesions and a decrease in post-operative range of motion and power. Main aims of tendon repair are improved tendon healing and adhesion reduction. Primary flexor tendon healing methods are still being refined to this day. Aim of the Work:The goal is to assess the outcomes of heparin injection into cut ends of flexor tendon zone II injuries both clinically and radiologically using musculoskeletal ultrasound.Patients and Methods: This is an interventional clinical trial including forty individuals with flexor tendon injuries zone II. The Patients were sampled randomly into two groups, group I twenty patients (study group) with heparin injection and group II twenty patients (control group) without heparin injection.Results: Forty cases were included in our study which had zone II flexor tendon injury repaired using four strand techniques. Both groups had the same protocol of physiotherapy and follow-up. Results were measured as regards the total range of motion according to Strickland criteria showing no significant change between the two groups. Heparin injection shows a higher rupture rate of flexor tendons which were injected also showing gap formation in MSK US. Also, heparin injection increases the formation of granulation tissue which negatively affects the gliding of tendon. So, heparin injection is not recommended in flexor tendon repair zone II. Conclusion:Heparin injection shows a higher rupture rate of flexor tendons which were injected also which reflect gap formation in MSK US. Also, heparin injection increases the formation of adhesive granulation tissue which negatively affects the gliding of tendon.So, heparin injection is not recommended in flexor tendon repair zone II. However, there were a few limitations to our 239 study such as poor compliance of some patients which is considered one of the major problems that affect the postoperative outcomes.

show abstract

Section: Discussionmentioning

confidence: 99%

The Effect of Heparin Injection Into Cut Ends of Flexor Tendon Zone II Injuries

Gadallah

Elbarbary

Abdelsalam

et al. 2022

The Egyptian Journal of Plastic and Reconstructive Surgery

View full text Add to dashboard Cite

show abstract

“…Different sutures have been studied, in vitro as well as in vivo, with different numbers of strands and knots, with the aim of achieving the greatest resistance while promoting the sliding of the tendon in its sheath, during mobilization, throughout the tendon healing period, which is estimated at 12 weeks on average [8][9][10][11][12][13].…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have emerged comparing two-strand and four-strand sutures over the past few years in patients with wounds in different areas or on multiple fingers [8][9][10][11][12]16]. These studies demonstrated the superiority of more than two strands, which would promote early mobilization with less risk of rupture during the critical period of tendon healing.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Modified Kessler and McLarney Techniques in Zone II Flexor Tendon Repair

Benameur¹,

Bensaleh²,

Chagou³

et al. 2022

Cureus

View full text Add to dashboard Cite

Hand injuries are common in the routine practice of any upper limb surgeon. The laceration of the flexor tendons can engage the functional prognosis of the hand. Hence, there exist a multitude pf suturing techniques whose goal is to have a solid repair, allowing an early rehabilitation. Our study aims at comparing the functional results after flexor tendon repairs in zone II using two different techniques, modified Kessler technique and McLarney technique. MethodsOur study included 42 patients, divided into two groups, one having benefited from the modified Kessler technique and the other from the McLarney technique. The modified Strickland classification was used to compare the functional results at six months after surgery of the two techniques. ResultsOur study showed a better post-operative functional outcome with a lower risk of post-operative rupture in patients operated with the McLarney four-strand technique compared to patients operated with the modified Kessler two-strand technique. ConclusionHand wounds in zone II remain a therapeutic challenge for any orthopedic surgeon due to the multiplicity of factors involved in the prognosis, in particular the type of suture. The suture with more than two strands has proven its effectiveness and its reproducibility, making it possible to find the balance sought by the surgeon, namely a suture that is not cumbersome, easy and quick to perform, and strong enough to start early rehabilitation.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Surgeons are wary about delay primary repair (Unsal et al, 2019), although it is possible and used commonly (Reito et al, 2019). Unsal et al (2019) sent a questionnaire about flexor tendon repair, and received 91 responses from international surgeons. Thirty-four per cent of respondents considered 3 weeks to be the maximum limit for primary repair, 32% considered the limit to be 4 weeks and 36% consider the limit to be 5 weeks.…”

Section: Discussionmentioning

confidence: 99%

Up to five-week delay in primary repair of Zone 2 flexor tendon injuries: outcomes and complications

Munz

Poggetti

Cenci

et al. 2021

J Hand Surg Eur Vol

View full text Add to dashboard Cite

We report the outcomes of delayed primary repair of flexor tendons in Zone 2 in 31 fingers and thumb (28 patients) averaging 15 days (range 4–37) after injury in 2020. The delay was longer than usual due to the COVID-19 pandemic. The tendons were repaired with a 6-strand core suture (M-Tang method) or a double Tsuge suture and a peripheral suture. This was followed by an early, partial-range, active flexion exercise programme. Adhesions in four digits required tenolysis. These patients were not with longest delay. Outcomes of two improved after tenolysis. The other two patients declined further surgery. One finger flexor tendon ruptured in early active motion. This was re-repaired, and final outcome was good. Overall excellent and good results using the Tang criteria were in 27 out of 31 fingers and thumbs (87%). The time elapsed between the injury and surgery is not an important risk factor for a good outcome, rather it depends on proper surgical methods, the surgeon's experience and early mobilization, properly applied. Adhesions may occur, but they can be managed with tenolysis. Level of evidence: IV

show abstract

Comparison of surgical trends in zone 2 flexor tendon repair between Turkish and international surgeons

Abstract: The role of the platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio in the prediction of length and cost of hospital stay in patients with infected diabetic foot ulcers: A retrospective comparative study

Cited by 7 publications

References 20 publications

The Effect of Heparin Injection Into Cut Ends of Flexor Tendon Zone II Injuries

The Effect of Heparin Injection Into Cut Ends of Flexor Tendon Zone II Injuries

Comparison of Modified Kessler and McLarney Techniques in Zone II Flexor Tendon Repair

Up to five-week delay in primary repair of Zone 2 flexor tendon injuries: outcomes and complications

Contact Info

Product

Resources

About