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Complications of flexor tendon repair in the hand: MR imaging assessment
J L Drapé1, O Silbermann-Hoffman, P Houvet
1Department of Skeletal Radiology, Hôpital Bichat 46, Paris, France.
Purpose:
To determine if magnetic resonance (MR) imaging enables differentiation of adhesions from tendon rupture after repair of digital flexor tendon injuries.
Materials And Methods:
The reference group comprised eight tendon sutures with a good clinical outcome. Axial and sagittal spin-echo sequences and three-dimensional gradient-echo sequences with curved reconstructions were analyzed in 63 injured fingers. Reoperation was performed in 41 fingers.
Results:
MR imaging depicted isolated peritendinous adhesions (n = 31), most often with a continuous, uniform tendon (sensitivity 91%, specificity 100%). There were two types of rupture: frank rupture (n = 140; sensitivity 100%, specificity 100%) or elongated callus (n = 18; sensitivity 100%, specificity 94%). Tendon gap was significantly longer in frank rupture (P = .0011). Thin fibrous continuity existed with elongated callus. Tenolysis was sufficient when the callus was short and mature with predominant new collagen fibers. Axial spin-echo sections were essential, as they showed the maturation of the callus.
Conclusion:
MR imaging may enable distinction among several complications that occur after repair of an injured digital flexor tendon.