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Staged flexor tendon reconstruction in the fingers and hand
P C Amadio1, M B Wood, W P Cooney
1Department of Orthopedics, Mayo Clinic, Rochester, MN 55905.
The Journal of Hand Surgery
|July 1, 1988
Summary
This study evaluated a two-stage tendon grafting technique for finger reconstruction. While 54% of patients achieved good or excellent results, factors like injury zone and age influenced outcomes.
Area of Science:
- Orthopedic Surgery
- Hand Surgery
- Reconstructive Surgery
Background:
- Tendon injuries significantly impact hand function.
- Effective tendon reconstruction is crucial for restoring finger mobility.
- Previous techniques had variable success rates.
Purpose of the Study:
- To evaluate the efficacy of a two-stage tendon grafting technique for finger reconstruction.
- To identify factors influencing outcomes in patients undergoing tendon grafting.
Main Methods:
- Retrospective review of 117 finger reconstructions in 89 patients (1973-1984).
- Utilized a two-stage tendon grafting approach.
- Assessed outcomes using Total Active Motion (TAM) as a percentage of Total Passive Motion (TPM).
Main Results:
- 54% of patients achieved good or excellent results based on TAM/TPM.
- 19% had a final TAM exceeding 180 degrees.
- Complications included infection (15%), rupture (4%), and amputation (4%).
- Zone I/II injuries and younger age (<10 years) correlated with poorer outcomes.
- Zone IV/V injuries and surgeon-supervised therapy correlated with better outcomes.
Conclusions:
- The two-stage tendon grafting technique offers moderate success in finger reconstruction.
- Patient age and injury zone are critical prognostic factors.
- Direct surgeon supervision of postoperative therapy enhances results.