Gadallah, A., Elbarbary, A., Abdelsalam, A., Gamal El Deen, N., Abdel Gawad, E. (2022). The Effect of Heparin Injection Into Cut Ends of Flexor Tendon Zone II Injuries. The Egyptian Journal of Plastic and Reconstructive Surgery, 46(3), 239-246. doi: 10.21608/ejprs.2022.254713
Ahmed Gadallah; Amir Elbarbary; Ahmed Abdelsalam; Noha M. Gamal El Deen; Ebrahim M. A. Abdel Gawad. "The Effect of Heparin Injection Into Cut Ends of Flexor Tendon Zone II Injuries". The Egyptian Journal of Plastic and Reconstructive Surgery, 46, 3, 2022, 239-246. doi: 10.21608/ejprs.2022.254713
Gadallah, A., Elbarbary, A., Abdelsalam, A., Gamal El Deen, N., Abdel Gawad, E. (2022). 'The Effect of Heparin Injection Into Cut Ends of Flexor Tendon Zone II Injuries', The Egyptian Journal of Plastic and Reconstructive Surgery, 46(3), pp. 239-246. doi: 10.21608/ejprs.2022.254713
Gadallah, A., Elbarbary, A., Abdelsalam, A., Gamal El Deen, N., Abdel Gawad, E. The Effect of Heparin Injection Into Cut Ends of Flexor Tendon Zone II Injuries. The Egyptian Journal of Plastic and Reconstructive Surgery, 2022; 46(3): 239-246. doi: 10.21608/ejprs.2022.254713
The Effect of Heparin Injection Into Cut Ends of Flexor Tendon Zone II Injuries
1The Departments of Plastic, Burn & Maxillofacial Surgery, Faculty of Medicine, Ain Shams University
2The Departments of Diagnostic & Interventional Radiology, Faculty of Medicine, Ain Shams University
Abstract
Background: Because the FDP (flexor digitorum profundus) and the two slips of the FDS (flexor digitorum superficialis) are crowded within a tight fibro-osseous tunnel, it has never been easy to have good functional results after flexor tendon restoration in zone II, elevating the possibility of postoperative adhesions and a decrease in post-operative range of motion and power. Main aims of tendon repair are improved tendon healing and adhesion reduction. Primary flexor tendon healing methods are still being refined to this day. Aim of the Work: The goal is to assess the outcomes of heparin injection into cut ends of flexor tendon zone II injuries both clinically and radiologically using musculoskeletal ultrasound. Patients and Methods: This is an interventional clinical trial including forty individuals with flexor tendon injuries zone II. The Patients were sampled randomly into two groups, group I twenty patients (study group) with heparin injection and group II twenty patients (control group) without heparin injection. Results: Forty cases were included in our study which had zone II flexor tendon injury repaired using four strand techniques. Both groups had the same protocol of physiotherapy and follow-up. Results were measured as regards the total range of motion according to Strickland criteria showing no significant change between the two groups. Heparin injection shows a higher rupture rate of flexor tendons which were injected also showing gap formation in MSK US. Also, heparin injection increases the formation of granulation tissue which negatively affects the gliding of tendon. So, heparin injection is not recommended in flexor tendon repair zone II. Conclusion: Heparin injection shows a higher rupture rate of flexor tendons which were injected also which reflect gap formation in MSK US. Also, heparin injection increases the formation of adhesive granulation tissue which negatively affects the gliding of tendon. So, heparin injection is not recommended in flexor tendon repair zone II. However, there were a few limitations to our 239 study such as poor compliance of some patients which is considered one of the major problems that affect the postoperative outcomes.
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