Single-Stage Flexor Tendon Reconstruction Using Tendon Grafting Versus Turnover Tendon Split-Lengthening Technique

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Reconstructive Surgery

Background:

• Flexor tendon injuries often require reconstruction when primary repair is not feasible.
• Single-stage reconstruction aims to restore function efficiently.
• Traditional tendon grafting and turnover split-lengthening are two techniques for secondary flexor tendon reconstruction.

Purpose of the Study:

• To compare long-term functional outcomes and complication rates of single-stage flexor tendon reconstruction.
• To evaluate traditional tendon grafting versus the turnover split-lengthening technique.
• To assess outcomes in patients with flexor tendon injuries unsuitable for primary repair.

Main Methods:

• Retrospective review of 14 patients undergoing single-stage flexor tendon reconstruction (2014-2022).
• Comparison of palmaris longus tendon grafts (n=7) versus turnover split-lengthening (n=7).
• Assessment of total active range of motion (AROM), grip strength, and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) scores.

Main Results:

• No significant differences in AROM, grip strength, or QuickDASH scores between the two techniques.
• Mean AROM was 67.6%, mean grip strength was 90.7% of the contralateral hand, mean QuickDASH score was 2.9.
• Complications occurred in 50% of patients, irrespective of reconstruction method, often correlating with poorer functional results.

Conclusions:

• Single-stage flexor tendon reconstruction using either tendon grafting or turnover split-lengthening yields comparable functional results.
• The turnover technique is a valuable alternative, especially when palmaris longus is unavailable.
• Both methods are associated with significant complication rates, underscoring the complexity of secondary tendon reconstruction.