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An evaluation of the two-stage flexor tendon reconstruction technique
The Journal of Hand Surgery
|May 1, 1983
Summary
Flexor tendon reconstruction using a two-stage approach, including tenolysis, significantly improved digital function in patients with scarred digits. This surgical method offers the best available option for restoring hand function after flexor tendon loss.
Area of Science:
- Orthopedic Surgery
- Hand Surgery
- Reconstructive Surgery
Background:
- Flexor tendon injuries in scarred digits present significant challenges for functional restoration.
- Two-stage reconstruction is a common approach, but outcomes require detailed evaluation.
Purpose of the Study:
- To evaluate the clinical outcomes of 43 two-stage flexor tendon reconstructions in 39 patients.
- To assess the effectiveness of tenolysis in improving results after initial reconstruction.
Main Methods:
- Review of 43 two-stage flexor tendon reconstructions in 39 patients.
- Grading results by comparing preoperative passive motion (stage one) to postoperative active motion (stage two) of interphalangeal joints.
- Analysis of outcomes before and after tenolysis for graft ruptures or adhesions.
Main Results:
- Initial results: 16% excellent, 23% good, 26% fair, 35% poor, with 3 graft ruptures.
- After tenolysis of 20 grafts (47%), results improved to 27% excellent, 28% good, 30% fair, and 16% poor.
- Tenolysis demonstrated a significant positive impact on overall functional outcomes.
Conclusions:
- Two-stage flexor tendon reconstruction, particularly when combined with tenolysis, is an effective method for restoring digital function.
- This staged approach, including tenolysis, is considered the optimal available treatment for flexor tendon loss in severely scarred digits.