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Injury to the flexor tendons of the fingers of the hand is a frequent and disabling injury, since it produces tendon retraction and functional limitation. A prompt and adequate diagnosis and treatment is required to minimize the risk of tendon retraction, re-rupture, reoperation rate, and the presence of tendon adhesions that limit the range of motion. On occasions, the limitation of the articular balance of the MCP, PIP and DIP joints generates a loss of strength and difficult in completely closing the fingers to the palm of the hand.
To retrospectively evaluate the results obtained with the suture/ reinsertion of the flexor tendons of the hand, in the acute, subacute and chronic phases, treated surgically in our center between the years 2000 and 2021.
To evaluate the clinical and functional results obtained in patients who underwent surgery for a section of the flexor tendons, superficial, profundus or both, preferably in zone II of the hand. The investigators evaluate the epidemiological and prognostic factors associated with the injury, in the different phases and anatomical zones.
The researchers evaluate the functional results:
Pain at rest with movements: Assessed using the visual analogue pain scale (VAS Scale from 0 to 10).
Joint balance / Range of motion of the MCP, PIP, DIP joints. Evaluation by digital goniometer. Evaluation using Buck-Gramcko (1976) and using the Tang (2007) criteria.
Grip strength. Evaluation using a Jamar dynamometer. Functional rating scales: QuickDASH Score Reoperation rate: 1) For re-rupture / re-suture, 2) For infection, 3) For excision of tendon adhesions: arthrolysis and tendolysis, 4) For tendon transfer 5) For tendon graft placement.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Repair: suture, reinsertion, tendon graft, surgery in two stages (Hunter, Paneva Holevich) | Procedure | Repair tendon flexor sections in the hand: Suture, reinsertion, tendon graft, surgery in two stages (Hunter, Paneva Holevich). The surgery depends on the anatomical area of the tendon section and the time between the injury and the operation. |
| Measure | Description | Time Frame |
|---|---|---|
| Range of motion (ROM) | Change in the mobility of the MCP, PIP and DIP joints. Evaluation with goniometer (cm) | 12 months |
| Grip Strength | Change of strength with respect to the contralateral hand. Evaluation with Jamar Dinamometer (Kg) | 12 months |
| Chronic residual pain | Evaluation residual pain at rest and with activity with the Visual Analogue Scale (values from 0 to 10; 0 is the better outcome and 10 is the worse outcome). | 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| Epidemiological variables age, sex, smoker, diabetes, heart disease, other diseases (lung, kidney, etc.). | Evaluacion of epidemiological factors associated with outcomes in flexor injuries. | 12 months |
| Trauma variables |
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Inclusion Criteria:
Exclusion Criteria:
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All patients between 18 and 85 years of age who have suffered a hand injury with section / s of the superficial and / or profundus flexor tendons, or both in hand; and flexor tendon in the thumb.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Claudia Lamas, MD. Ph D | Contact | 935537032 | clamasg@santpau.cat | |
| Claudia Lamas, MD, Ph D | Contact | 935537032 | clamasg@santpau.cat |
| Name | Affiliation | Role |
|---|---|---|
| Claudia Lamas, MD, Ph D | Fundació Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Claudia Erika Delgado Espinoza | Recruiting | Barcelona | 08025 | Spain |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 2732428 | Result | Doyle JR. Anatomy of the flexor tendon sheath and pulley system: a current review. J Hand Surg Am. 1989 Mar;14(2 Pt 2):349-51. doi: 10.1016/0363-5023(89)90110-x. | |
| 3049854 | Result | Manske PR. Flexor tendon healing. J Hand Surg Br. 1988 Aug;13(3):237-45. doi: 10.1016/0266-7681_88_90077-0. |
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| ID | Term |
|---|---|
| D012092 | Replantation |
| D013514 | Surgical Procedures, Operative |
| ID | Term |
|---|---|
| D014180 | Transplantation |
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Affected finger, dominant hand, involvement of one or more fingers, type of injury (complete / partial section / association with fractures /association with arterial injury/ association with nerve injury/ section only FP or section FS plus FP).
| 12 months |
| 17298858 | Result | Tang JB. Indications, methods, postoperative motion and outcome evaluation of primary flexor tendon repairs in Zone 2. J Hand Surg Eur Vol. 2007 Apr;32(2):118-29. doi: 10.1016/J.JHSB.2006.12.009. Epub 2007 Feb 12. |
| 8169485 | Result | Tang JB. Flexor tendon repair in zone 2C. J Hand Surg Br. 1994 Feb;19(1):72-5. doi: 10.1016/0266-7681(94)90054-x. |
| 28610452 | Result | Moriya K, Yoshizu T, Tsubokawa N, Narisawa H, Matsuzawa S, Maki Y. Outcomes of flexor tendon repairs in zone 2 subzones with early active mobilization. J Hand Surg Eur Vol. 2017 Nov;42(9):896-902. doi: 10.1177/1753193417715213. Epub 2017 Jun 13. |
| 4045137 | Result | Amadio PC, Hunter JM, Jaeger SH, Wehbe MA, Schneider LH. The effect of vincular injury on the results of flexor tendon surgery in zone 2. J Hand Surg Am. 1985 Sep;10(5):626-32. doi: 10.1016/s0363-5023(85)80197-0. |
| 925330 | Result | Lundborg G, Myrhage R, Rydevik B. The vascularization of human flexor tendons within the digital synovial sheath region--structureal and functional aspects. J Hand Surg Am. 1977 Nov;2(6):417-27. doi: 10.1016/s0363-5023(77)80022-1. |
| 992488 | Result | Buck-Gramcko D, Dietrich FE, Gogge S. [Evaluation criteria in follow-up studies of flexor tendon therapy]. Handchirurgie. 1976;8(2):65-9. German. |
| 23660061 | Result | Tang JB. Outcomes and evaluation of flexor tendon repair. Hand Clin. 2013 May;29(2):251-9. doi: 10.1016/j.hcl.2013.02.007. |
| 10722813 | Result | Strickland JW. Development of flexor tendon surgery: twenty-five years of progress. J Hand Surg Am. 2000 Mar;25(2):214-35. doi: 10.1053/jhsu.2000.jhsu25a0214. No abstract available. |