Is microsurgical experience essential in Zone II flexor tendon injuries?
Department of Orthopedics and Traumatology, Private Silivri Anadolu Hospital, Istanbul, Türkiye
Keywords: Arterial injury, bone fractures, flexor tendon injury, microsurgery, nerve injury, treatment outcome.
Objectives: This study aims to investigate whether microsurgical experience was necessary for the treatment of Zone II flexor tendon injuries.
Patients and methods: Between October 2018 and October 2021, a total of 73 Zone II flexor tendon injuries in 71 patients (53 males, 18 females; mean age: 39.6±12.1 years; range, 21 to 57 years) who underwent surgical intervention in our center were retrospectively analyzed. All patients in the study had flexor digitorum profundus (FDP) tendon injury. The clinical outcomes of patients with digital artery injury, nerve injury or phalanx fracture accompanying FDP tendon injury were evaluated separately according to the American Society for Surgery of the Hand (ASSH) scores. The scores of multiple injuries accompanying FDP tendon injury in patients with FDP+flexor digitorum superficialis (FDS)+digital nerve injury and FDP+FDS+digital artery+nerve injury were evaluated.
Results: The mean ASSH score was 69.4±28.2 in the group with FDP tendon injury accompanying digital nerve injury and 62.9±19.7 in the group with FDP tendon injury and digital artery injury. The clinical outcomes were significantly lower in patients with digital nerve injury and digital artery injury respectively, compared to patients without accompanying injuries (p=0.029 and p=0.012, respectively). The lowest mean score (45.3±10.2) was in patients with fracture accompanying FDP tendon injury and ASSH score was significantly lower than in patients without fracture (p<0.001).
Conclusion: Zone II flexor tendon injuries are frequently accompanied by digital artery or nerve injuries, which usually require microsurgical repair. If left untreated, treatment outcome may be poor. Surgical centers and departments undertaking the treatment of flexor tendon injuries should be able to perform microsurgery
Citation: Pamuk Ç. Is microsurgical experience essential in Zone II flexor tendon injuries?. Jt Dis Relat Surg 2023;34(1):183-189. doi: 10.52312/jdrs.2023.931
The study protocol was approved by the Istanbul Medipol University Non-Invasive Clinical Research Ethics Committee (date: 14.10.2022, no: E-10840098-772.02-6196). The study was conducted in accordance with the principles of the Declaration of Helsinki.
A written informed consent was obtained from each patient.
Data Sharing Statement:
The data that support the findings of this study are available from the corresponding author upon reasonable request.
The author declared no conflicts of interest with respect to the authorship and/or publication of this article.
The author received no financial support for the research and/or authorship of this article.