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The button-over-nail technique for Zone I flexor tendon injuries.
1Department of Plastic and Reconstructive Surgery, Whiston Hospital, Whiston, Prescot L35 5DR, UK. bidwai2000@yahoo.co.uk
Summary
The "button over the nail" technique for flexor digitorum profundus tendon repair in Zone 1 injuries has low surgical complications but yields poor functional outcomes. Further research should balance complication rates with functional results for optimal patient recovery.
Area of Science:
- Orthopedic Surgery
- Hand Surgery
- Musculoskeletal Research
Background:
- The "button over the nail" technique is standard for Zone 1 flexor digitorum profundus tendon reinsertion.
- Concerns exist regarding the morbidity associated with this common surgical method.
Purpose of the Study:
- To evaluate the surgical complications and functional outcomes of the "button over the nail" technique.
- To compare the efficacy of this technique against other methods for Zone 1 flexor tendon injuries.
Main Methods:
- Retrospective review of 37 patients treated with the "button technique" for Zone 1 injuries.
- Analysis of prospective hand therapist audit data for functional outcomes.
- Assessment of post-operative surgical complication incidence.
Main Results:
- The "button over the nail" technique demonstrated a low rate of surgical complications.
- Functional outcomes were relatively poor, with a mean distal interphalangeal joint range of motion of 37.5 degrees.
- Comparison with other studies suggests suboptimal functional recovery.
Conclusions:
- While surgical complication rates are low, the functional outcomes of the "button over the nail" technique are a concern.
- Future decisions on surgical technique should prioritize functional outcomes alongside complication rates.
- Further investigation into alternative techniques for Zone 1 flexor tendon injuries is warranted.
