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Title: Comparison of Outcome Between Early and Delayed Repair of Flexor Tendons
Authors: Aiman Naseem, Faisal Akhlaq Ali, Hyder Ali, Usamah bin Waheed, Mehak Ali, Saima Tasleem
Journal: Pakistan Armed Forces Medical Journal (PAFMJ)
Publisher: Army Medical College, Rawalpindi.
Country: Pakistan
Year: 2024
Volume: 74
Issue: 3
Language: English
Keywords: Flexor tendon repairFunctional outcomeLaceration of flexor tendonSurgery timings
Objective: To determine the association of functional outcome for flexor tendon repair for the surgery timings.
Study Design: Case Series.
Place and Duration of Study: Plastic and Reconstructive Surgery Department, Dr Ruth KM Pfau Civil Hospital, Karachi Pakistan, from Apr to Sep 2021.
Methodology: A total of 98 patients were equally divided into the early duration of tendon repair and the delayed duration of tendon repair. Patients were assessed to evaluate the functional outcome of flexor tendon repair in terms of tendon power assessed by the MRC scale, active movement at joints and the incidence of rupture. Functional outcome was assessed as Excellent (75-100), Good (50-74), Fair (24-49) and Poor (0-24).
Results: In early repair, tendon power on the second post-operative day was observed as 11(22%) patients had movement against gravity but were powerless than normal, and 39(78%) patients had maximum strength. In comparison, in delayed repair, 5(10%) patients had movement against gravity but not against resistance, and 45(90%) patients had movement against gravity but were more powerless than normal. The active motion on the second post-operative day in early repair cases, 47(94%) patients had excellent active motion, while 30(60%) patients had good active motion in delayed repair. The tendon rupture was found 4(8%) in early repair and 10(20%) in delayed repair.
Conclusion: Early tendon repair had excellent active motion and a lower ratio of tendon rupture than delayed repair.
To determine the association of functional outcome for flexor tendon repair with surgery timings.
Case Series. Plastic and Reconstructive Surgery Department, Dr Ruth KM Pfau Civil Hospital, Karachi Pakistan, from April to September 2021. 98 patients were divided into early (within 14 days) and delayed (after 14 days) repair groups. Functional outcomes were assessed using the MRC scale for tendon power, active joint movement, and incidence of rupture. Outcomes were categorized as Excellent (75-100), Good (50-74), Fair (24-49), and Poor (0-24).
graph TD
A["Patient Recruitment n=98"] --> B["Divide into Groups"];
B --> C["Early Repair Group <= 14 days"];
B --> D["Delayed Repair Group > 14 days"];
C --> E["Assess Functional Outcome"];
D --> E;
E --> F["Analyze Data"];
F --> G["Compare Outcomes"];
G --> H["Conclusion"];
The study suggests that early flexor tendon repair leads to superior functional outcomes, particularly in terms of active motion, and a lower rate of tendon rupture compared to delayed repair. The findings align with international literature advocating for timely intervention in flexor tendon injuries.
Early repair resulted in significantly better active motion on the second postoperative day (94% excellent) compared to delayed repair (60% good, 40% fair). Tendon rupture was lower in early repair (8%) than in delayed repair (20%), though this difference was not statistically significant.
Early flexor tendon repair is associated with excellent active motion and a lower tendon rupture ratio compared to delayed repair.
- A total of 98 patients were included in the study. (Confirmed in Methodology)
- Early repair was defined as tendon repair within 14 days of surgery. (Confirmed in Methodology)
- Tendon rupture was found in 4 (8%) patients in the early repair group. (Confirmed in Results)
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