Tobler-Ammann, Bernadette Christina; Beckmann-Fries, Vera; Calcagni, Maurizio; Kämpfen, Alexandre; Schrepfer, Lorena; Vögelin, Esther (2023). Outcomes of Primary Flexor Tendon Repairs in Zones 2 and 3: A Retrospective Cohort Study. Journal of hand surgery global online, 5(4), pp. 445-453. Elsevier 10.1016/j.jhsg.2023.03.016
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PURPOSE
The aims of this retrospective cohort study were to present outcomes of zone 2 and 3 primary flexor tendon repairs and to evaluate how clinical outcomes change over time within and between zones of injury at weeks 6, 13, and 26.
METHODS
Data were retrieved from a multicenter flexor tendon cohort registry from 2014 to 2021. The inclusion criteria were: (1) adult patients after primary flexor tendon surgery in zone 2 or 3, (2) flexor digitorum profundus laceration of >50%, (3) 4-6 multistrand flexor digitorum profundus core suture, and (4) early active motion protocol. The primary outcome was the range of motion. Secondary outcomes were strength, patient satisfaction on an 11-point Likert scale, and self-reported physical function measured with the Disability of the Arm, Shoulder, and Hand questionnaire 6, 13, and 26 weeks after surgery.
RESULTS
We evaluated 33 patients after 39 tendon repairs in zone 3 and 174 repairs in zone 2 of 163 patients. Range of motion significantly improved over time in both zones (P < .001 to .01). Between-group range of motion differences were nonsignificant except for week 26 (P < .001) for the zone 3 group. Hand strength significantly improved in both zones over time (P < .001 to .01), while between-zone strength differences were statistically nonsignificant (P = .37 to .93). Patient satisfaction was generally good to high (mean 6.8 to 8.0 points) with significant within-group changes in both zones (P < .001). There were no relevant between-zone differences in Disability of the Arm, Shoulder, and Hand scores at any time point.
CONCLUSIONS
Patients had significantly improved clinical outcomes in both zones. The zone of injury significantly affected the total active motion scores at the final assessment after 26 weeks for the zone 3 injuries. For the secondary outcomes hand strength, patient satisfaction, and Disability of the Arm, Shoulder, and Hand scores, we discovered no significant between-group differences.
TYPE OF STUDY/LEVEL OF EVIDENCE
Therapeutic IV.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Plastic and Hand Surgery 04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Plastic and Hand Surgery > Hand Surgery |
UniBE Contributor: |
Tobler, Bernadette, Vögelin, Esther |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
2589-5141 |
Publisher: |
Elsevier |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
02 Aug 2023 07:52 |
Last Modified: |
02 Aug 2023 08:01 |
Publisher DOI: |
10.1016/j.jhsg.2023.03.016 |
PubMed ID: |
37521557 |
Uncontrolled Keywords: |
Clinical outcomes Cohort Flexor tendon injury Zone 2 Zone 3 |
BORIS DOI: |
10.48350/185149 |
URI: |
https://boris.unibe.ch/id/eprint/185149 |
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