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Staged flexor tendon reconstruction fingertip to palm
Michael P Coyle1, Timothy P Leddy, Joseph P Leddy
1Section of Orthopaedic Surgery, Department of Surgery, St. Peter's University Hospital and Robert Wood Johnson University Hospital, 215 Easton Avenue, New Brunswick, NJ 08901, USA.
The Journal of Hand Surgery
|July 20, 2002
Summary
Staged flexor tendon reconstruction for fingertip to palm injuries achieved 69% good to excellent results. This method preserves natural digit function and requires minimal tendon grafts, offering a viable surgical option.
Area of Science:
- Orthopedic Surgery
- Hand Surgery
- Reconstructive Surgery
Background:
- Flexor tendon injuries, particularly those extending from fingertip to palm, present complex reconstructive challenges.
- Previous primary tenorrhaphies may fail, necessitating advanced surgical techniques.
- Staged reconstruction offers a potential solution for complex flexor tendon defects.
Purpose of the Study:
- To evaluate the outcomes of fingertip to palm staged flexor tendon reconstructions.
- To identify factors influencing the success of this reconstructive technique.
Main Methods:
- Retrospective review of 35 fingertip to palm staged flexor tendon reconstructions performed between 1971 and 1998.
- Analysis of tendon injuries including avulsions and lacerations, with or without failed primary tenorrhaphies.
- Assessment of outcomes based on total active motion (TAM) at an average 30-month follow-up.
Main Results:
- Overall, 69% of patients achieved good to excellent results (TAM >= 200 degrees).
- Excellent (>=220 degrees), good (200-219 degrees), fair (180-199 degrees), and poor (<180 degrees) TAM were achieved in 13, 11, 7, and 4 patients, respectively.
- Less favorable outcomes were associated with longer intervals between injury and surgical stages and higher injury severity.
Conclusions:
- Fingertip to palm staged flexor tendon reconstruction yields a high rate of good to excellent functional outcomes.
- This technique effectively utilizes the injured profundus tendon as a motor and preserves lumbrical function.
- The method conserves tendon graft length, often requiring only the palmaris longus tendon.