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Fractures: Bone Repair

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Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
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Tenolysis rate after zone 2 flexor tendon repairs.

Osman Civan¹, M Kemal Gürsoy, Ali Cavit

¹Elmalı Devlet Hastanesi Ortopedi ve Travmatoloji Kliniği, 07716 Elmalı, Antalya, Türkiye. civanosman@gmail.com.

Joint Diseases and Related Surgery

|June 26, 2020

Summary

Repairing flexor digitorum profundus (FDP) and flexor digitorum superficialis (FDS) tendons in zone 2 increases tenolysis rates. Patient gender and the number of injured fingers did not significantly impact these rates.

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Area of Science:

Orthopedic surgery
Hand surgery
Reconstructive surgery

Background:

Zone 2 flexor tendon injuries are common in the hand.
Optimal surgical techniques and rehabilitation protocols are crucial for successful outcomes.
Adhesions and subsequent tenolysis are potential complications following flexor tendon repair.

Purpose of the Study:

To evaluate the tenolysis rates for zone 2 flexor digitorum profundus (FDP) and flexor digitorum superficialis (FDS) tendon repairs.
To assess the influence of the four-strand technique and early passive motion on tenolysis rates.
To determine if patient gender or the number of injured fingers affects tenolysis rates.

Main Methods:

Retrospective analysis of 149 patients (194 tendons) undergoing zone 2 flexor tendon repair.
Repairs utilized modified Kessler and Bunnell techniques with a four-strand construct.
Postoperative management included early passive motion per modified Duran's protocol, with no active flexion until week 4.

Main Results:

A tenolysis rate of 14.43% (28 out of 194 fingers) was observed.
No statistically significant correlation was found between tenolysis rate and the number of operated fingers (p=0.836).
No statistically significant correlation was found between tenolysis rate and patient gender (p=0.584).

Conclusions:

Repairing both FDP and FDS tendons in zone 2 is associated with an increased tenolysis rate.
Tenolysis rates in zone 2 flexor tendon repairs are independent of the number of injured fingers and patient gender.
Early passive motion protocols may influence adhesion formation and the need for tenolysis.