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Pediatric flexor tendon injuries: A 10-year outcome analysis
Sheena Sikora1, Michelle Lai2, Jugpal S Arneja1
1Division of Plastic Surgery, British Columbia Children's Hospital and University of British Columbia;
Summary
Pediatric flexor tendon injuries in zones I-III, often caused by glass, show excellent outcomes (95.9%) with appropriate repair and immobilization. Hand therapy is crucial for rehabilitation in young patients.
Area of Science:
- Orthopedic Surgery
- Pediatric Hand Surgery
- Traumatology
Background:
- Flexor tendon repair has advanced significantly since the 1960s, yet pediatric outcomes remain understudied.
- Pediatric tendon injuries present unique challenges due to smaller anatomy and compliance issues.
- Reported good outcomes for pediatric flexor tendon repair are as low as 53%.
Purpose of the Study:
- To analyze pediatric flexor tendon injuries (zones I-III) over a decade.
- To identify injury patterns, demographics, and treatment paradigms for optimal outcomes.
Main Methods:
- Retrospective chart review of pediatric flexor tendon injuries (zones I-III) from 2001-2010.
- Data collected included demographics, injury mechanism, repair technique, and outcomes.
- Outcomes assessed using the American Society for Surgery of the Hand Total Active Motion (TAM) score.
Main Results:
- 47 pediatric patients (median age 8) sustained 100 tendon injuries, most commonly from glass.
- Zone III injuries were most frequent, involving flexor digitorum superficialis and profundus tendons.
- 95.9% of patients achieved 100% TAM score recovery, with 4-week immobilization and hand therapy proving safe and effective.
Conclusions:
- Pediatric flexor tendon injuries typically involve the dominant hand and objects like glass.
- Excellent functional recovery (95.9% TAM) is achievable with appropriate surgical repair and postoperative care.
- Four-week immobilization is safe for young children and does not negatively impact functional outcomes.
