Background: Over the past few years, there has been a
shift in how flexor tendons are repaired. Because of adhesions
or ruptures that occurred when early active motion was attempted,
flexor tendon repairs in the digit have a long history
of producing disappointing outcomes.
Objectives: To make an evaluation to the outcomes of
flexor tendon repair using ordinary 4 strands suture with intratendinous
knot technique and comparing it with four strands
suture with extracorporeal knot. And comparing it with our innovation
technique; The four-strand suture with extracorporeal
knot.
Subjects and Methods: This interventional prospective trial
was performed on persons admitted to our emergency hospital
and Burn and Plastic Surgery Center, Mansoura University
with flexor tendon injuries zone II from February 2020 to February
2023. Patients were classified into two groups; group A
treated with the 4-strand suture with extra corporeal knot, and
group B treated with the 4-strand suture with intra tendinous
knot.
Results: Statistical analysis revealed a statistically significant
distinction among the groups according to outcome, total
active flexion (TAF) and total active range of motion (TARM)
for group A, and operation time for group B. No statistically
significant variations were observed amongst the groups
as regard socio-demographic characteristics, injury location
& dominant hand distribution among the study populations,
anesthesia WALAIAT or General, follow up period, patient or
parent's satisfaction, age and outcome of treatment.
Conclusion: We noticed that the four strands suture with
extracorporeal knot technique for flexor tendons repair zone II
was easy to accomplish, had a lower volume and no bulk at the
site of repair, with no suture knot inside tendon at site of repair,
besides a more regular suture, that offer less interfering with
tendon gliding, less adhesion formation, adequate strong repair
for an early active post-operative mobilization protocol, good
results, good total active range of motion and good patients
satisfaction.