Flexor Digitorum Superficialis Tendon Injuries in Zone II (to Repair or Not) | ||
| The Egyptian Journal of Plastic and Reconstructive Surgery | ||
| Articles in Press, Accepted Manuscript, Available Online from 25 June 2023 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejprs.2023.214491.1280 | ||
| Authors | ||
| Ahmed Gadallah* 1; Adnan Gamal Etman2; mohamed mamdouh abdel halim3 | ||
| 1plastic and reconstructive surgery department , faculty of medicine , Ain Shams university, cairo , Egypt | ||
| 2MSc , Plastic, Burn and Maxillofacial surgery department, Ain shams university, Cairo, Egypt | ||
| 3plastic and maxillofacial surgery departement Ain Shams University | ||
| Abstract | ||
| Background: Attaining favorable functional results after flexor tendon repair in zone II has always been a complex task. This is primarily due to the cramped positioning of the flexor digitorum profundus (FDP) and the two slips of the flexor digitorum superficialis (FDS) within a narrow fibro-osseous tunnel which significantly increases the risk of postoperative adhesions and consequent limitations in range of motion. Aim: to evaluate the clinical outcomes after surgery by assessing postoperative range of motion (ROM) and radiological findings using Musculoskeletal Ultrasound (MSK US). Specifically, we aim to compare the results between cases where both the flexor digitorum profundus (FDP) and flexor digitorum superficialis (FDS) tendons are repaired in Zone II flexor tendon injuries, and cases where only the FDP tendon is repaired. Patients and Methods: This interventional clinical trial involves fifty individuals with flexor tendon injuries in zone II who underwent surgery at El Dmerdash Hospital, based on the inclusion and exclusion criteria outlined in our study. A random sampling method was employed to divide the patients into two groups. Group I consist of twenty-five patients (the study group) who underwent repair of both the flexor digitorum profundus (FDP) and flexor digitorum superficialis (FDS) tendons. Group II comprises twenty-five patients (the control group) who underwent repair of only the FDP tendon. Results: 50 cases with four strand repairs of zone II flexor tendon injuries were considered. The rehabilitation and follow-up procedures were the same for both groups. According to Strickland criteria, the results were measured in terms of total range of motion and revealed significant differences between the two groups. Group with repair of both FDP and FDS has a higher range of motion. MSK US showed a higher rate of granulation tissue formation in group I but was not statistically significant. Conclusion: We recommend repairing both FDP tendon and FDS tendon to keep the integrity of full motion of the digit. Repairing both slips of FDS in addition to FDP tendon may increase the granulation tissue formation which impairs gliding but that can be avoided by routine post operative physiotherapy and avoid bulky intra operative repair. | ||
| Keywords | ||
| Flexor Tendon; Zone II; adhesion; range of motion | ||
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