Flexor Tendon Repair Techniques: M-Tang Repair

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Rehabilitation Medicine

Background:

• Zone 2 digital flexor tendon injuries are common and challenging to treat.
• Early active motion is crucial for optimal tendon healing and functional recovery.
• The M-Tang repair technique offers a method for early mobilization.

Purpose of the Study:

• To evaluate the outcomes of M-Tang repairs with early active flexion for zone 2 digital flexor tendons across multiple institutions.
• To assess the incidence of repair ruptures and the need for tenolysis.
• To identify factors influencing repair integrity, particularly during the COVID-19 pandemic.

Main Methods:

• Retrospective analysis of six institutes employing M-Tang repairs and early active flexion protocols.
• Data collection on repair integrity, functional outcomes (excellent to good results), and complications such as ruptures and tenolysis.
• Comparison of outcomes between pre-pandemic and pandemic periods, and across different institutes.

Main Results:

• Excellent to good outcomes were achieved in 80-90% of cases.
• Overall, repair ruptures were rare, with incidences of 0-1% in Nantong, Yixing, and Saint John, and 3% in Florence and Heidelberg.
• One institute observed an increase in ruptures during the pandemic, potentially linked to reduced therapy supervision.

Conclusions:

• M-Tang repair combined with early active flexion is a highly effective method for zone 2 digital flexor tendon injuries.
• The technique demonstrates a low complication rate, with minimal need for tenolysis.
• Maintaining strict therapy supervision is important to prevent aggressive patient mobilization and potential repair ruptures, especially in periods of altered healthcare delivery.