Background: Adhesion formation after tendon injury is
a challenging clinical problem.
Aim: We compare the outcome of reconstructing the flexor
tendon sheath after primary flexor tendon repair using an
autogenous vein graft to reduce post-operative peritendinious
adhesions.
Methods: Eight patients have acute flexor tendon injuries
of both FDS and FDP in zone II in more than one digit.
Primary tenorrhaphy was done using traditional technique.
In one-digit vein graft was used to reconstruct tendon sheath
window, while in the other digit, the tendon sheath left
untreated. Post-operative physiotherapy program of controlled
active motion is used for both group. All patients were assessed
using the second Buck-Gramcko scale at 2 and 6 months.
Results: For the vein graft group, 2 patient had excellent
result, 2 had very good, and 4 patients had good result. In
group II, 2 patients had very good result, 2 patients had good
result, and 4 patients had fair result.
Conclusion: The use of autologous vein graft as a substitute
of tendon sheath is a good treatment modality. Compared to
conventional tendon repair technique, it was associated with
less adhesion formation and less joint contracture.
Evidence Based Medicine: Level IV, vase series.