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Published on: December 10, 2021
Extensor Tendon Repair Outcomes Based on Zone of Injury
Stewart S Dalton1, Laura M Maharjan2, Hayyan Yousuf2
1JPS Health Network, Fort Worth, TX, USA.
Background:
The purpose of this study was to examine the clinical outcomes of extensor tendon repairs based on zone of injury.
Methods:
A retrospective chart review was conducted on all patients who underwent primary extensor tendon repair at our institution. Extensor tendon repairs were performed using a multiple figure-of-8 suture technique for extensor zones 1-4 and a modified Kessler suture technique for extensor zones 5-8. Inclusion criteria included a minimum of 8 weeks of follow-up, complete data available for review, and extensor tendon injury requiring primary surgical repair.
Results:
A total of 132 digits were included for analysis: 46 digits in zones 1-4 and 86 digits in zones 5-8. The operative time for zone 1-4 injuries averaged 88.96 minutes, and the operative time for zone 5-8 injuries averaged 114.42 minutes. Final extension was found to be 2.33° for zones 1-4 and 6.66° for zones 5-8. Final flexion was found to be 141.4° for zones 1-4 and 195.3° for zones 5-8. There was 1 infection identified in zones 1-4 and 7 in zones 5-8.
Conclusions:
Surgically repaired extensor tendons in zones 1-4 were found to have a statistically significant worse final flexion compared with surgically repaired extensor tendons in zones 5-8. No significant differences were found in final extension, complication rates, and time to full activity. Operative times for zone 5-8 tendon repairs were found to be significantly longer than operative times for zone 1-4 repairs, possibly due to more complex injury patterns seen in the more proximal zones.
