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Partial lacerations of flexor tendons in children. Primary repair versus conservative treatment
1Rambam Medical Center, Technion-Israel Institute of Technology, Haifa, Israel.
Insights
Early mobilization is effective for treating partially lacerated flexor tendons in children, yielding favorable outcomes comparable to surgical repair. This conservative approach avoids complications and is recommended for clinical diagnoses of partial flexor tendon division.
Area of Science:
- Pediatric Orthopedics
- Hand Surgery
- Traumatology
Background:
- Partial flexor tendon lacerations in children present a clinical challenge.
- Treatment options include surgical repair versus conservative management with early mobilization.
- Outcomes and complication rates for these approaches require comparison.
Purpose of the Study:
- To compare the clinical outcomes of surgical repair versus early mobilization for partially lacerated flexor tendons in pediatric patients.
- To evaluate the incidence of complications in both treatment groups.
- To establish evidence-based recommendations for managing partial flexor tendon injuries in children.
Main Methods:
- A comparative study involving 17 children with partially lacerated flexor tendons (less than 75% cross-sectional area) treated surgically.
- A control group of 19 children with similar injuries treated conservatively with early mobilization.
- Assessment of functional outcomes and complications in both groups.
Main Results:
- Both surgical repair and conservative early mobilization resulted in similarly favorable outcomes for pediatric patients with partial flexor tendon lacerations.
- No instances of triggering or complete tendon tear were observed in either treatment group.
- The study found no significant difference in complication rates between the two management strategies.
Conclusions:
- Early mobilization is a safe and effective conservative treatment for children diagnosed with partial flexor tendon division.
- Surgical exploration should be reserved for cases with diagnostic uncertainty to rule out complete tendon division.
- Conservative management with early mobilization should be considered the primary treatment approach for clinically diagnosed partial flexor tendon injuries in pediatric hand surgery.
Abstract:
We compared the outcome of 17 partially lacerated (less than 75% of cross-sectional area) flexor tendons in children treated by surgical repair to that of 19 tendons treated conservatively by early mobilization. The outcome of both groups was similarly favourable. No complications, such as triggering or complete tendon tear, were found in either group. We advocate early mobilization in children in whom a partial division of the flexor tendon is diagnosed clinically. Exploration should be carried out only in doubtful cases to exclude complete division of the tendon.