Functional outcomes after flexor tendon repair of the hand

Spark, Taryn; Godlwana, L.; Ntsiea, Veronica; Plooy, Eileen du; Rensburg, Charl Janse van

doi:10.5606/tftrd.2019.2137

Cited by 8 publications

(7 citation statements)

References 30 publications

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“…Despite scheduled visits, and multiple attempts to contact patients for final measurements, there was a high attrition rate after 6 months in our cohort. While this is consistent with the literature on attrition in orthopedic trauma, 71 – 75 more patients with long-term data are needed to adequately compare 9-month data to the earlier timepoints (3 and 6 months).…”

Section: Discussionsupporting

confidence: 82%

Evaluation of postoperative outcomes in patients following multi-level surgical reconstructions with the use Avive^™ soft tissue membrane on nerve after traumatic injury of the upper extremity and lower extremity

et al. 2021

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Background: Treatment of patients with traumatic axonotmesis presents challenges. Processed human umbilical cord membrane has been recently developed with improved handling and resorption time compared to other amniotic membrane wraps, and may be beneficial in nerve reconstruction. This study evaluates postoperative outcomes after traumatic peripheral nerve injury after placement of commercially available processed human umbilical cord membrane. Methods: We performed a prospective, single-center pilot study of patients undergoing multi-level surgical reconstruction for exposed, non-transected peripheral nerve. Functional outcomes including pain, range of motion, pinch and grip strength, and the QuickDASH and SF-36 patient-reported outcome measures were recorded, when possible, at the 1-week and 3, 6, and 9 months postop visit. One-tailed paired t-tests were performed to evaluate outcome improvement at final follow-up. Results: Twenty patients had processed human umbilical cord membrane placement without surgical complications. Mean follow-up was 7.5 months (range: 3–10 months) and mean age was 39 years (range: 15–65). Twelve (67%) patients were male, and the majority of placement sites were in the upper extremity (85%). Mean preoperative visual analog scale pain score was significantly reduced at most recent follow-up, as were QuickDASH scores. All patients had improved functional outcomes at the 9-month follow-up, and SF-36 outcomes at 9 months showed improvement across all dimensions. Conclusion: This study indicates that processed human umbilical cord membrane may be a useful adjunct in nerve surgery with noted improvements in postoperative function, pain, and patient-reported outcome measures. Future studies are needed to assess long-term outcomes after traumatic nerve injury treated with processed human umbilical cord membrane.

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Section: Discussionsupporting

confidence: 82%

Evaluation of postoperative outcomes in patients following multi-level surgical reconstructions with the use Avive^™ soft tissue membrane on nerve after traumatic injury of the upper extremity and lower extremity

et al. 2021

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“…In a study, performed on 23 patients, the infection rate was 16% (3 patients) 18 , while in another study on 65 patients, the rate of infection was reported 9% 19 . The infection rate in this study was 11.8%.…”

Section: Discussionmentioning

confidence: 90%

“…Range of motion between two methods of immediate and delayed primary repair were not significant, which is similar to the study of Navali et al 26 . The rate of tendon rupture after repair was 6% in the study of Spark et al 27 .…”

Section: Discussionmentioning

confidence: 90%

Short-Term and Long-Term Therapeutic Results of Deep Flexor Tendon Repair in Zone II in Patients Referred To Imam Khomeini Hospital, Ahvaz, Southern Iran

Mohammadhoseini,

Mohammadi,

Mousavi Nia

2024

WJPS

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Background: Hand injury as an important concern for the surgeon and the patient requires proper and timely treatment to prevent complications such as infection and adhesions, and with a proper rehabilitation program, the patient returns to maximum function as soon as possible. We aimed to investigate the short-term and long-term treatment results of deep flexor tendon repair in in zone II. Methods: This retrospective study was performed on 34 patients with 45 injured fingers in the zone II referred to Ahvaz Imam Khomeini Hospital, Ahvaz, Iran during 2017-2019. The results of deep flexor tendons repair in two groups, immediate and delayed primary repair were assessed. Results: The mean age of the patients was 27.76 years. There was no significant remarkable between male and female in the incidence of complications such as infection, tendon rupture and adhesions. 29.4% (n=10) had poor outcome, 8.8% (n=3) had fair outcome, 29.4% (n=10) had good outcome and 32.4% (n=11) had excellent outcomes. 26.5% had adhesion and infection rate was 11.8%. Conclusion: Among surgeons, there is consensus for the primary repair of tendon injury, but there was no significant difference between the results of immediate and delayed primary repair. Although physiotherapy has been suggested as an effective factor in improving hand function, its positive effect on the range of motion of the fingers has not been proven.

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“…8–10 Compared to patients with primary flexor tendon repair, who have a mean QuickDASH score of 19.3, patients who require two-stage tendon reconstruction have a mean QuickDASH score of 34.4, emphasizing the importance of successful primary repair. 11…”

Section: The Mechanical Impact Of Failed Flexor Tendon Repairmentioning

confidence: 99%

“…8-10 Compared to patients with primary flexor tendon repair, who have a mean QuickDASH score of 19.3, patients who require two-stage tendon reconstruction have a mean QuickDASH score of 34.4, emphasizing the importance of successful primary repair. 11 Flexor tendon pulley injury and tendon bowstringing can contribute to poor results. The pulley system consists of several fibro-osseous tunnels that run from the metacarpal head to the distal interphalangeal joint.…”

mentioning

confidence: 99%

Secondary Procedures following Flexor Tendon Reconstruction

Gillis

Moran

2021

Plastic &Amp; Reconstructive Surgery

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he incidence of flexor tendon injury is 33 injuries per 100,000 person-years. 1,2 Advancements in flexor tendon repair, including wide-awake surgery, have led to improved outcomes. 3 In studies using multiple strand repairs and active range of motion, excellent results (defined as total active range of motion more than 150 degrees 4 ) have been noted in up to 86 percent of cases. 5,6 Despite this, reoperation still occurs. In a retrospective review of 5229 patients undergoing primary flexor tendon repair, there was a 6 percent reoperation rate, with 58 percent of these patients requiring tenolysis alone, 38 percent requiring rerepair alone, and 4 percent requiring both. 7 In such cases, the surgeon must have an understanding of the available reconstructive options for the treatment of patients with neglected, failed, or scarred tendon repairs. This article will review the indications and management options for failed flexor tendon surgery. THE MECHANICAL IMPACT OF FAILED FLEXOR TENDON REPAIRComplications following flexor tendon repairs include decreased range of motion, tendon bowstringing, quadriga, and lumbrical-plus deformity. 8-10 Compared to patients with primary flexor tendon repair, who have a mean QuickDASH score of 19.3, patients who require two-stage tendon reconstruction have a mean QuickDASH score of 34.4, emphasizing the importance of successful primary repair. 11 Flexor tendon pulley injury and tendon bowstringing can contribute to poor results. The pulley system consists of several fibro-osseous tunnels that run from the metacarpal head to the distal interphalangeal joint. These tunnels hold the tendons close to the joint's axis, allowing maximal motion for small amounts of tendon excursion. Biomechanical cadaver studies show an 8.5 percent increase in tendon excursion with loss of the A2 pulley, a 9.9 percent increase with loss of the A4 pulley, and a 33.7 percent increase with loss of both A2 and A4. 12 The loss of both pulleys leads to a 107 percent increase in the work of flexion. 12 This can lead to loss of motion and joint contracture. Pulley damage can be avoided by accessing and performing the tendon repair through the cruciate pulleys. Recent reports have shown that

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Functional outcomes after flexor tendon repair of the hand

Cited by 8 publications

References 30 publications

Evaluation of postoperative outcomes in patients following multi-level surgical reconstructions with the use Avive^™ soft tissue membrane on nerve after traumatic injury of the upper extremity and lower extremity

Evaluation of postoperative outcomes in patients following multi-level surgical reconstructions with the use Avive^™ soft tissue membrane on nerve after traumatic injury of the upper extremity and lower extremity

Short-Term and Long-Term Therapeutic Results of Deep Flexor Tendon Repair in Zone II in Patients Referred To Imam Khomeini Hospital, Ahvaz, Southern Iran

Secondary Procedures following Flexor Tendon Reconstruction

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Functional outcomes after flexor tendon repair of the hand

Cited by 8 publications

References 30 publications

Evaluation of postoperative outcomes in patients following multi-level surgical reconstructions with the use Avive™ soft tissue membrane on nerve after traumatic injury of the upper extremity and lower extremity

Evaluation of postoperative outcomes in patients following multi-level surgical reconstructions with the use Avive™ soft tissue membrane on nerve after traumatic injury of the upper extremity and lower extremity

Short-Term and Long-Term Therapeutic Results of Deep Flexor Tendon Repair in Zone II in Patients Referred To Imam Khomeini Hospital, Ahvaz, Southern Iran

Secondary Procedures following Flexor Tendon Reconstruction

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Evaluation of postoperative outcomes in patients following multi-level surgical reconstructions with the use Avive^™ soft tissue membrane on nerve after traumatic injury of the upper extremity and lower extremity

Evaluation of postoperative outcomes in patients following multi-level surgical reconstructions with the use Avive^™ soft tissue membrane on nerve after traumatic injury of the upper extremity and lower extremity