Long-term follow-up of primary flexor pollicis longus tenorrhaphies

This study retrospectively analyzes primary flexor pollicis longus repairs. Ninety-four patients were identified and had extensive chart review. Thirty patients returned for follow-up (mean of 6.8 years) interview, range of motion, and strength testing. At follow-up, interphalangeal active range of motion, metacarpophalangeal active range of motion, and carpometacarpal active range of motion was 68 degrees, 48 degrees, and 46 degrees, respectively. Comparisons between active range of motion for the injured and noninjured hands revealed percentage differences of 71, 82, and 96% for the interphalangeal, metacarpophalangeal, and carpometacarpal joints. The percentage differences between active range of motion and passive range of motion for the injured metacarpophalangeal and interphalangeal joints were 71% and 75%. Injured thumbs had averages of 6.7, 7.0, 5.4, and 30.6 kg for the key, chuck, thumb-index pinches and JAMAR grip mean. The percentage differences of injured to uninjured hands in these tests were 91%, 84%, 92%, and 92%. Factors that appear to have a consistently negative effect on outcome include mechanism of injury and associated damage. Factors that did not uniformly affect outcome included zone of injury, age, sex, and postoperative splinting.