Six-Strand Flexor Pollicis Longus Tendon Repairs With and Without Circumferential Sutures: A Multicenter Study

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Musculoskeletal Research

Background:

• Flexor pollicis longus (FPL) tendon injuries require effective surgical repair.
• The 6-strand core suture technique is a common method for FPL repair.
• The role of circumferential sutures in addition to core sutures is not fully elucidated.

Purpose of the Study:

• To compare outcomes of FPL tendon repairs using a 6-strand core suture technique with and without circumferential sutures.
• To evaluate the impact of circumferential sutures on functional recovery and patient satisfaction.

Main Methods:

• A comparative study involving 49 patients with FPL tendon injuries.
• Patients were divided into two groups: circumferential suture (C group, n=33) and non-circumferential suture (NC group, n=16).
• Postoperative management included a dorsal blocking splint and early active motion protocol. Outcome measures assessed at 6, 13, and 26 weeks included range of motion, strength, functional scores (Kapandji, DASH), and patient satisfaction.

Main Results:

• No significant differences in range of motion or hand/thumb strength were observed between the C and NC groups.
• Both groups demonstrated improvement in outcome measurements over time.
• Patient satisfaction levels were similar in both treatment groups. Tendon re-rupture occurred in 4 patients in the C group and 1 patient in the NC group.

Conclusions:

• The 6-strand suture technique is effective for FPL tendon repair, enabling early active motion.
• Circumferential sutures are not essential for achieving good surgical outcomes in FPL tendon repairs.
• Omitting circumferential sutures is a viable option, potentially simplifying the procedure without compromising functional results.