Akademik Veri Yönetim Sistemi
2025 IFSSH-IFSHT World Congress, Washington, Amerika Birleşik Devletleri, 24 - 28 Mart 2025, ss.1, (Özet Bildiri)
Hypothesis:
This study presents the results of primary flexor tendon repairs in zones 1 and
2 which are delayed up to 6 months.
Methods: Patients
were enrolled to the study from our database from 2018 to 2022 if their flexor
tendon was repaired primarily at least 7 days after the injury. We included
only zone 1-2 injuries and excluded thumbs. WALANT is the standard method of
anesthesia in tendon repairs in our clinic. All the patients were treated
according to the controlled active mobilization protocol in a dorsal blocking
splint post-operatively. Assessments included total active motion (TAM) and
Disabilities of Arm, Shoulder and Hand (DASH) questionnaire at the 6th,
8th and 12th weeks. Extensor deficit was also noted at
the final assessment.
Results: We
identified 33 patients from the records. Six patients were excluded (2 of them
were injured on the thumb, 2 did not complete the treatment and 2 were not
native in our language). A total of 27 patients with 32 fingers were included
in the analysis. Mean age was 31.2±9.2 and 17 patients were male (63%).
Twenty-six fingers were injured in zone 2 and 6 fingers on zone 1. There were eight
second finger, 3 third finger, 10 fourth finger and 11 fifth finger injuries.
Twenty-one fingers had only flexor digitorum profundus (FDP) injury and the
others had both flexors injury. The
delay between the injury and the surgical repair was 7- 180 days with a mean of
30±34 days. Two patients required fractional lengthening of FDP after intraoperative
active motion testing. TAM scores increased by time (201±26, 223±27 and 246±20°, respectively) and DASH scores
decreased (28.1±15.1, 16.1±6.3 and
8.9±10.9, respectively)
(p<0.01). Extensor deficit was apparent in 25 fingers with a maximum of 20° at the final assessment.
Summary
Points: This study showed that flexor tendon primary repair is still possible
even within 6 months after the initial injury. We concluded that WALANT made
the intraoperative active flexion-extension test and tension control possible in
the awake patient and thus, unnecessary reconstructive procedures were avoided.
It is also thought that patients benefited from early controlled motion.
Extension deficit seen at 3 months would improve by time as tendon healing
requires several months. Therefore, further follow-up for extension recovery is
recommended.