El Gazzar, K., Gad, A., amr, A. (2022). Zone II Thumb Flexor Tendon Repair: A Functional Outcome Report. The Egyptian Journal of Plastic and Reconstructive Surgery, 46(4), 323-331. doi: 10.21608/ejprs.2022.269070
Khaled El Gazzar; Ahmed Mohamed Gad; Adel Hussein amr. "Zone II Thumb Flexor Tendon Repair: A Functional Outcome Report". The Egyptian Journal of Plastic and Reconstructive Surgery, 46, 4, 2022, 323-331. doi: 10.21608/ejprs.2022.269070
El Gazzar, K., Gad, A., amr, A. (2022). 'Zone II Thumb Flexor Tendon Repair: A Functional Outcome Report', The Egyptian Journal of Plastic and Reconstructive Surgery, 46(4), pp. 323-331. doi: 10.21608/ejprs.2022.269070
El Gazzar, K., Gad, A., amr, A. Zone II Thumb Flexor Tendon Repair: A Functional Outcome Report. The Egyptian Journal of Plastic and Reconstructive Surgery, 2022; 46(4): 323-331. doi: 10.21608/ejprs.2022.269070
Zone II Thumb Flexor Tendon Repair: A Functional Outcome Report
The Department of Plastic, Reconstructive and Maxillofacial Surgery, Faculty of Medicine, Ain Shams University
Abstract
Background: Although the utmost importance of the thumb to hand biomechanics, the reports discussing thumb flexor tendon repair are few if compared to other digits. A reliable report for flexor tendon repair should include a standard surgical technique, rehabilitation and evaluation protocols, and the outcomes in correlation to the surgeons' level of expertise. We report our experience in management of flexor pollicis longus (FPL) tendon injuries at zone II. Patients and Methods: Between 2015 and 2022, a retrospective study included 26 patients with zone II FPL tendon injuries were included. By using a goniometer, the percent of the total active range of motion in comparison to the contralateral thumb was assessed and graded according to Tang criteria of assessment. Results: The follow-up period ranged from 7 to 28 months with average 10.5 months. The total active thumb range of motion was graded excellent in 15.3% (n=4), good in 42.3% (n=11), fair in 30.7 (n=8), poor in 11.5% (n=3), and zero incidence of tendon rupture. The only documented major complication was poor functional outcome that needed a session of tenolysis. The remaining of the complications were managed conservatively. The zone V retrieval incision showed the least functional outcome and were used in 8 patients. Seven out of the 8 patients were graded as poor to fair and only one patient was graded as good. Among 20 repairs done by level 4 surgeons, 60% (n=12) of patients showed excellent to good functional outcome grading, and 25% (n=5) incidence of minor complications. Among 6 repairs done by level 3 surgeons, only 50% (n=3) of patients showed excellent to good functional outcome grading, and 33% (n=2) incidence of complications, one was major complication that needed another session of tenolysis. Conclusion: In consideration to its importance, more studies should be directed to report the FPL tendon injuries. The reports including the surgeons' level of expertise are more informative and reliable for interpretation of the functional outcome.
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