Complications after flexor tendon surgery: A retrospective cohort study of 336 patients

The management of flexor tendon injuries in the hand is a well-known challenge worldwide, and postoperative complications have been reported with a pronounced incidence. However, little is known about possible associations with adverse events following surgery.

The aim of this study was to report outcomes and incidence of postoperative complications in patients undergoing surgery after traumatic flexor tendon injuries in the hand.

We retrospectively reviewed medical records of 336 patients who had been surgically treated for flexor tendon injuries of the hand in two hospitals in the period of 2010-2020. We divided patients in groups and compared those with major complications (n = 56) to those without (n = 280). Major postoperative complications were defined as rerupture, adhesion leading to surgery and infection leading to revision and/or admission.

In total, 17 % experienced a major complication following surgery. We found that 7.7 % of patients experienced rerupture of the sutured tendon, 6.5 % of patients experienced adhesion leading to tenolysis and 2.4 % experienced infection leading to revision and/or admission. Traumas in zone II of the hand and lesions in both flexor digitorum superficialis and profundus were both separately associated with a greater risk of major complications (OR 2.132 and OR 2.317, respectively).

The incidence of patients experiencing major complications following flexor tendon surgery is 17 %, and patients with traumas in zone II of the hand and multiple tendon lesions have a higher risk of experiencing a major postoperative complication.