Flexor Tendon Injuries in the Pediatric Population.

Area of Science:

• Orthopedics
• Pediatric Surgery
• Hand Surgery

Background:

• Flexor tendon injuries in children present unique diagnostic and therapeutic challenges.
• These injuries are uncommon but require careful management to optimize functional outcomes.

Purpose of the Study:

• To describe the epidemiologic characteristics of pediatric flexor tendon injuries.
• To evaluate the outcomes of surgical treatment for these injuries in children.

Main Methods:

• Retrospective study of pediatric patients with acute traumatic flexor tendon injuries (2012-2019).
• Analysis of demographics, injury mechanisms, surgical techniques, complications, and functional results using the Total Active Mobilization score.
• Inclusion of 20 patients (34 tendons) with a median follow-up of 7 months.

Main Results:

• The predominant demographic was male (n=16), with most injuries occurring via cuts (n=17) in the 4th digit and Verdan's zone II.
• The Modified Kessler technique with polypropylene sutures was most common; 75% of patients achieved a Total Active Mobilization score >75%.
• Stiffness was the primary complication (37%), more frequent in patients over 10 years and those with zone II lesions, but without significant functional impact.

Conclusions:

• Pediatric flexor tendon injuries are infrequent, with a male predominance and common occurrence in zone II.
• While stiffness is a frequent complication, surgical intervention leads to favorable functional results in the majority of pediatric patients.
• Age over 10 years and zone II lesions are associated with increased complication rates, though functional outcomes remain positive.