[Secondary flexor tendon reconstructions - how good are they?]

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Reconstructive Surgery

Background:

• Secondary flexor tendon reconstructions are infrequently performed due to advances in primary repair techniques.
• These procedures remain indicated for complex cases requiring specialized surgical intervention.
• This study evaluates outcomes from a tertiary hand center, comparing them to existing literature.

Purpose of the Study:

• To present the results of secondary flexor tendon reconstructions performed at a supra-regional hand center.
• To compare these outcomes with previously published data, both recent and historical.
• To assess the efficacy of different secondary reconstruction methods.

Main Methods:

• A retrospective analysis of 52 secondary flexor tendon reconstructions out of 644 total repairs over 11 years.
• Categorization into single-staged reconstructions (7), tendon transpositions (16), and two-staged reconstructions (29).
• Patient outcomes were evaluated using the Buck-Gramcko system, with 39 patients assessed.

Main Results:

• Single-staged reconstructions achieved excellent to good results in 60% of cases.
• Tendon transpositions yielded functional results in 75% of patients.
• Two-staged reconstructions resulted in functional outcomes in 50% of cases, with an overall functional result of 58.5% for all secondary reconstructions.

Conclusions:

• Secondary flexor tendon reconstructions constitute approximately 7.5% of all flexor tendon injuries.
• Functional results have shown minimal improvement over decades, suggesting limitations in current techniques.
• Optimizing primary flexor tendon repair is crucial to minimize the necessity for secondary reconstructions.