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. 2024 Feb 15:6:1269861.
doi: 10.3389/fmedt.2024.1269861. eCollection 2024.

Current clinical opinion on surgical approaches and rehabilitation of hand flexor tendon injury-a questionnaire study

Ruikang Xue  1 , Jason Wong  2   3 , Angela Imere  1   4 , Heather King  5 , Peter Clegg  6   7 , Sarah Cartmell  1   4
Affiliations

Current clinical opinion on surgical approaches and rehabilitation of hand flexor tendon injury-a questionnaire study

Ruikang Xue et al. Front Med Technol. .

Abstract

The management of flexor tendon injury has seen many iterations over the years, but more substantial innovations in practice have been sadly lacking. The aim of this study was to investigate the current practice of flexor tendon injury management, and variation in practice from the previous reports, most troublesome complications, and whether there was a clinical interest in potential innovative tendon repair technologies. An online survey was distributed via the British Society for Surgery of the Hand (BSSH) and a total of 132 responses were collected anonymously. Results showed that although most surgeons followed the current medical recommendation based on the literature, a significant number of surgeons still employed more conventional treatments in clinic, such as general anesthesia, ineffective tendon retrieval techniques, and passive rehabilitation. Complications including adhesion formation and re-rupture remained persistent. The interest in new approaches such as use of minimally invasive instruments, biodegradable materials and additive manufactured devices was not strong, however the surgeons were potentially open to more effective and economic solutions.

Keywords: clinical opinion; flexor tendon; repair; retrieval; survey.

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Conflict of interest statement

HK is Director of Addos Consulting Ltd. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The authors declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

Figures

Figure 1
Figure 1
Results of anesthesia used for flexor tendon repair (A), use of atraumatic tendon retrieval (B), tendon retrieval techniques (C) and challenges in tendon retrieval (D).
Figure 2
Figure 2
Results of repair techniques, suture materials and suture gauge on primary (A) and peripheral tendon repair (B). *Checked – 2 strand repairs, solid – 4 strand repairs and hatched – 6 strand repairs.
Figure 3
Figure 3
Results of rehabilitation protocol (A), average hand tendon repair operation time (B), and most common complications (C).
Figure 4
Figure 4
Clinical opinions on new approaches to treat hand flexor tendon injuries.
See this image and copyright information in PMC

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