Tendon Injuries of the Hand in Kirikkale, Turkey

Abstract

Background: Tendon injuries are one of the most common injuries of the hand and challenging problems in trauma surgery. They usually require surgical repair and unlike the single tendon injuries, flexor tendon injuries have higher morbidities when accompanied with nerve injuries. In the present study, I aimed to report the clinical experiences and outcomes about tendon injuries.

Methods: A total of 180 patients (149 males, 31 females) between 17 and 56 years old were operated in the clinic due to tendon injury. Seventy isolated extensor tendon injuries, 60 isolated flexor tendon injuries, 30 multiple flexor tendon and major nerve injuries, 18 combined extensor and flexor tendon injuries, and 2 combined extensor, flexor and major nerve injuries were treated. All patients were admitted to the clinic in acute phase and operated immediately. Physiotherapy was started in the third day of the operation.

Results: Patients were followed up between 6 and 18 months (mean 12.4 months). There was not any major complications except one female patient (0.5%) who did not conform to the treatment protocol after flexor tendon injury. Fifteen patients (8.5%) had poor flexor range of motion. The other patients were healed uneventfully.

Conclusion: Tendon healing may cause some complications from mild to severe degrees. However, atraumatic surgery and a comprehensive postoperative early physiotherapy could decrease these complication rates.

Keywords: Hand; Injury; Physiotherapy; Tendon.

Fig. 1

Shematic description of the asymmetrical modified Kessler repair technique

Fig. 2

A 35 years old male patient with 4th and 5th deep and superficial flexor tendon sharp injuries. It demostrates intraoperative repair with modified Kessler technique. A2 pulleys were protected during surgery

Figs. 3

a: A 25 years old male patient with extensor pollicis longus injury. b: was taken after surgical repair

Figs. 4

a: A 39 years old female patient with extensor tendon injury. b: demonstrates the exploration of the proximal and distal ends of the tendon. c: was taken after repair

Figs. 5

a: A 27 years old male patient with multiple extensor tendon injury at the level of Forearm. b: is intraoperative. c and d: are postoperative 12 months view of the scar. Full extension of the fingers could be seen in these figures

Figs. 6

a: A 37 years old male patient with both flexor and extensor tendon and superficial radial nerve injuries. b and c: are postoperative 14 months views, full extension could be seen in these figures

Figs. 7

a: Preoperative picture of 20 years old male patient with 1st, 2nd, and 3rd flexor tendons, palmaris longus, flexor carpi radialis, partial median nerve injuries. b: is intraoperative. c and d: are postoperative 12 months photos of active range of motion of the hand