The outcome of Flexor Tendon Repair based on the number of core suture, mechanism and zone of injury in Erbil

Shams Ramadhan Hamzah; Jalal Hamasalih Fattah

doi:10.15218/zjms.2018.001

Authors

Shams Ramadhan Hamzah Department of Surgery, College of Medicine, Hawler Medical University, Erbil, Iraq.
Jalal Hamasalih Fattah Department of Surgery, College of Medicine, Hawler Medical University, Erbil, Iraq.

DOI:

https://doi.org/10.15218/zjms.2018.001

Keywords:

Flexor tendon, Core suture, Zone of injury, Mechanism of injury

Abstract

Background and objective: Principles of surgical treatment of flexor tendon injuries include early primary repair with a strong core stitch combined with an epitendinous suture. This study aimed to evaluate the outcomes of primary flexor tendon repair according to the mechanism, zone of injury and number of core sutures.

Methods: This study was conducted in Erbil from May 2013 till March 2015. Injured flexor tendons were repaired for 121 patients. The patients were followed up for six months. We used the Strickland scoring system to evaluate the results.

Results: Sharp tools represented the main cause of trauma 68.6%, excellent results were found in 51.8% of cases with a sharp injury. The worst results were obtained in zone II with 44.7% fair to a poor result. Excellent results found in 43.4% with four strand core sutures while 24.4% in two strand core sutures (P ˂0.01).

Conclusion: Four strand core sutures have the better result with a low rate of tendon rupture than two strand core sutures. Sharp injuries had better results than crush injuries. The zone with worst results was zone II.

Metrics

Metrics Loading ...

References

-Frank V, Chris J, Nick L, Mark G, William W. Stress relaxation and creep viscoelastic properties of common suture -materials used for flexor tendon repair. JHS 2008; 33:241-6.

-Christopher D, Aaron D, Huong D, Alexia S. Robert M, Stephen L. The epidemiology of reoperation after flexor tendon repair. JHS 2012; 37:919-24.

-Yrjana N, Nina L, Sauli P, Sanna R, Nadja R. Flexor tendon injuries in pediatric patients. JHS 2007; 32:1549-57.

-Trevor S, Rebecca S, Kenneth M. Clinical outcomes of zone II Flexor tendon repair depending on mechanism of injury. JHS 2012; 37:2532-40.

-Marissa R, Warren C. Flexor Tendon Rehabilitation. JHS 2012; 37A:2386-8.

- Mordechai V, Ram P, Rachel G, Vipul P, Phillip N, Steve L. Biomechanical study of cross-locked cruciate versus Strickland flexor tendon repair. JHS 2008; 33:1826-33.

-Atwal N, Sheriff D, Cawey A. Flexor tendon injuries. OAT 2010; 24: 217-22.

- Jin T, Peter A, Martin B, Robert S, Chunfeng Z, Michael S, et al. Current practice of primary flexor tendon repair a global view. HC 2013; 21: 1-11.

-Arash M, Emily G, James C. Complications after flexor tendon injuries. HC 2009; 26:179-89.

-Brian M, Bradon J, Elvin G, Michael W. Flexor tendon reconstruction. CPS 2011;38:607-19.

- Rudge J, James M. Flexor tendon injuries in the hand a UK survey of repair techniques and suture materials are we following the evidence. ISRN PS 2014; 1:1-4.

-Maurizio C, Monia B, Marco F, Galeazzo C, Silvio T, Francesco P. The four-strand staggered suture for flexor tendon repair in Vitro biomechanical study. JHS 2010; 32:948-55.

- Mike H, Gregory N, Stavros T, Matthew S, Rosalina D, Richard G. Technical and biological modifications for enhanced flexor tendon repair. JHS 2010; 35:1031-7.

- David E, Thomas G. Primary flexor tendon surgery the search for a perfect result. HC 2013; 29:191-206.

-Julianne H, Fiona P. Rehabilitation of flexor and extensor tendon injuries in the hand. IJCI 2013; 44:397-402.

- Jin T. Outcomes and evaluation of flexor tendon repair. HC 2013; 29:251-9.