Clinical differences between nasogastric tube and Hunter's rod for staged Zone II flexor tendon reconstruction

This study aims to compare the outcomes of two-stage flexor tendon reconstruction in Zone II of the hand and to evaluate the results of a nasogastric tube as a potential alternative to Hunter's rod.

Between November 2012 and January 2022, a total of 45 patients (26 males, 19 females; median age: 31 years; range, 12 to 61 years) who underwent two-stage flexor tendon reconstruction were retrospectively analyzed. Of the patients 24 underwent nasogastric tube reconstruction (NT group) and 21 underwent Hunter's rod reconstruction (HR group). Patients' demographic and clinical characteristics, the number of surgeries, the occurrence of complications, the presence of infection during the procedure, and the range of motion of the finger joints at the final follow-up examination were recorded. The assessment of the cases was conducted using the total active motion system.

Twenty-four digits underwent two-stage flexor tendon reconstruction with the nasogastric tube. Among these, three index fingers, nine middle fingers, seven ring fingers, and five little fingers were operated. Twenty-one digits underwent two-stage flexor tendon reconstruction using Hunter's rod. Among these, two index fingers, eight middle fingers, six ring fingers, and five little fingers were operated. In the NT group, excellent results were observed in 58.3% (14 digits), good results in 25% (six digits), fair results in 8.3% (two digits), and poor results in 8.3% (two digits). In the HR group, excellent results were seen in 57.1% (12 digits), good results in 33.3% (seven digits), fair results in 4.7% (one digit), and poor results in 4.7% (one digit).

The utilization of a nasogastric tube offers a convenient and cost-effective option to Hunter's rod in the two-stage flexor tendon reconstruction, leading to favorable outcomes characterized by high rates of excellence and improvement, while effectively minimizing the occurrence of complications.