Relationship between pain, nerve injury and clinical outcomes after flexor tendon injuries in zones 1-2: a retrospective cohort study.

Beckmann-Fries, Vera; Calcagni, Maurizio; Schrepfer, Lorena; Kaempfen, Alexandre; Vögelin, Esther; Tobler-Amman, Bernadette (2023). Relationship between pain, nerve injury and clinical outcomes after flexor tendon injuries in zones 1-2: a retrospective cohort study. Hand therapy, 28(2), pp. 60-71. Sage 10.1177/17589983231159187

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INTRODUCTION

The influence of pain and a concomitant digital nerve injury on the course of rehabilitation after flexor tendon injury remains ambiguous. The objectives of the study were to: i) analyse the evolution of pain spanning one year after a primary flexor tendon repair in zones 1-3; ii) examine the differences in pain levels in patients with and without digital nerve injury; and iii) evaluate the relationship between pain, digital nerve injury and pain medication, total active motion (TAM), DASH scores and patient satisfaction.

METHODS

Data from 189 patients were retrieved from a flexor tendon registry between 2014 and 2020. Differences in pain, TAM, DASH and patient satisfaction were analysed. Multiple linear and binary logistic regression analyses were performed to determine the relationship between clinical outcomes.

RESULTS

Pain significantly decreased in the course of rehabilitation (p < 0.001 to 0.006). No relationship could be identified between nerve injury and pain (p = 0.21-0.97). In week 6, the presence of pain and a nerve injury were significantly associated with lower TAM scores (p = 0.001). In week 13, pain during motion (p < 0.001) and the presence of a nerve injury (p = 0.036) were significantly associated with worse DASH scores. Patient satisfaction was significantly inversely correlated to pain during motion in weeks 13 and 26 (p < 0.001).

CONCLUSION

We found a significant relationship between pain during motion and pain medication intake, TAM, DASH scores and patient satisfaction. It is therefore advisable to closely monitor this parameter after flexor tendon injuries.

STUDY REGISTRATION

This multi-center cohort study is registered under https://clinicaltrials.gov: NCT04312412.

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
UniBE Contributor:	Vögelin, Esther, Tobler, Bernadette
Subjects:	600 Technology > 610 Medicine & health
ISSN:	1758-9991
Publisher:	Sage
Language:	English
Submitter:	Pubmed Import
Date Deposited:	31 Oct 2023 14:41
Last Modified:	31 Oct 2023 14:41
Publisher DOI:	10.1177/17589983231159187
PubMed ID:	37904861
Uncontrolled Keywords:	flexor tendon repair nerve injury pain rehabilitation
URI:	https://boris.unibe.ch/id/eprint/188447