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Tenolysis after combined digital injuries in zone II
Simone Eggli1, Andreas Dietsche, Stefan Eggli
1Department of Orthopaedic, Plastic & Reconstructive and Hand Surgery, Division of Hand Surgery, University of Bern, Inselspital, CH-3010 Bern, Switzerland.
Abstract:
A retrospective review of 23 patients with restricted motion after 32 combined digital injuries or amputations in zone II treated with tenolysis was conducted at an average follow-up of 5 years. Significant functional improvement was achieved in 28 out of 32 digits (88%). Total active motion improved on average 51 degrees after dorsal tenolysis, 55 degrees after palmar tenolysis, and 63 degrees after combined dorsopalmar tenolysis. Using the Buck-Gramcko scoring system, 15 digits reached excellent results, 8 showed a good result, 4 had a fair result, and 5 were rated as poor. No digits were lost. All patients returned to a full-time job. Complications consisted of 16% flexor tendon ruptures after palmar or combined tenolyses. In contrast, dorsal tenolysis proved to be a safe procedure. Prerequisites for success are compliant patients who are willing to undergo therapy for at least 3 months postoperatively. Despite the demanding postoperative therapy, the individual patient satisfaction is high following tenolysis.