[Single-stage flexor tendoplasty in the treatment of flexor tendon injuries]

Abstract

Objectives: We evaluated tendon reconstruction with one-stage tendon grafting in flexor tendon injuries in which primary repair was not considered because of delay in treatment or of inappropriate circumstances on the part of the wound and the patient.

Methods: Thirty-seven patients (29 males, 8 females; mean age 20.5 years; range 4 to 52 years) underwent single-stage flexor tendoplasty involving 41 fingers. Twenty-eight patients had zone II injuries. The mean duration from trauma to surgery was one month (range 3 to 6 weeks). Tendon grafts were obtained from the palmaris longus in 26 repairs, flexor digitorum superficialis in 14 repairs, and flexor carpi radialis in one repair. Early passive rehabilitation was administered after surgery. Improvement in the flexion motion was calculated using the Strickland formula. The results were compared with respect to the tendon graft used, associated nerve injuries, and the age of the patients (equal to or below 10 years/above 10 years). The mean follow-up was 35 months (range 4 to 83 months).

Results: Functional results were excellent in 12 fingers (29.3%), good in 13 fingers (31.7%), moderate in 14 fingers (34.2%), and poor in two fingers (4.9%). Overall, the mean total active movement was 57% (range 22 to 88%). No significant differences were found between the functional results with respect to the tendon graft used, associated nerve injuries, and the age of the patients (ANOVA, p>0.05).

Conclusion: Single-stage flexor tendoplasty seems to be an appropriate choice of treatment for flexor tendon injuries where local wound conditions and decreased tendon length prevent primary repair, provided that the pulley system remains intact.