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Updated: Aug 11, 2025

A Novel Tenorrhaphy Suture Technique with Tissue Engineered Collagen Graft to Repair Large Tendon Defects
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Extensor Tendon Repair Outcomes Based on Zone of Injury.

Stewart S Dalton1, Laura M Maharjan2, Hayyan Yousuf2

  • 1JPS Health Network, Fort Worth, TX, USA.

Hand (New York, N.Y.)
|February 3, 2023
PubMed
Summary
This summary is machine-generated.

Extensor tendon repairs in zones 1-4 showed worse final flexion than zones 5-8, but complication rates and time to activity were similar. Zone 5-8 repairs took longer, possibly due to injury complexity.

Keywords:
anatomybasic sciencediagnosisdigitsforearmhandsoft tissue reconstructiontendontrauma

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Area of Science:

  • Orthopedic Surgery
  • Hand Surgery
  • Reconstructive Surgery

Background:

  • Extensor tendon injuries are common in the hand.
  • Surgical repair is the primary treatment for extensor tendon injuries.
  • Outcomes can vary based on the zone of injury.

Purpose of the Study:

  • To compare clinical outcomes of extensor tendon repairs based on the zone of injury.
  • To identify differences in functional recovery and complications between different extensor tendon zones.

Main Methods:

  • Retrospective chart review of 132 patients undergoing primary extensor tendon repair.
  • Analysis of outcomes for zones 1-4 (figure-of-8 suture) and zones 5-8 (modified Kessler suture).
  • Inclusion criteria: minimum 8-week follow-up, complete data, primary surgical repair.

Main Results:

  • Zone 1-4 repairs averaged 88.96 minutes; Zone 5-8 repairs averaged 114.42 minutes.
  • Final flexion was 141.4° for zones 1-4 and 195.3° for zones 5-8.
  • Infection rates were 1 in zones 1-4 and 7 in zones 5-8.

Conclusions:

  • Extensor tendons repaired in zones 1-4 had significantly worse final flexion compared to zones 5-8.
  • No significant differences in final extension, complication rates, or time to full activity.
  • Longer operative times for zone 5-8 repairs may reflect more complex injuries.