The outcomes of zone 1 flexor tendon injuries treated using micro bone suture anchors

This article evaluates the outcome of 42 consecutive zone 1 flexor tendon injuries treated by using micro bone anchors during the period 2003–2008. Patients were rehabilitated using the modified Belfast Regime. The range of motion at the distal interphalangeal joint was assessed using Moiemen’s classification. A total of 56% of patients achieved excellent or good results for range of motion at the distal interphalangeal joint and 23% had a poor outcome. The mean distal interphalangeal joint and proximal interphalangeal joint range of motion were 48° and 96°, respectively. A total of 94% of patients returned back to work by 12 weeks. One patient sustained a tendon rupture and one developed osteomyelitis. The mean QuickDASH score was 13.5 and 81% of patients were satisfied with their outcomes. This is the largest clinical study on the use of bone anchors for zone 1 tendon injuries. Our study demonstrated a low rate of complications and outcomes that compare favourably with other published techniques.

[1]  F. Iwuagwu,et al.  A comparative analysis of the outcome of flexor tendon repair in the index and little fingers: does the little finger fare worse? , 2012, The Journal of hand surgery, European volume.

[2]  D. Ruchelsman,et al.  Avulsion Injuries of the Flexor Digitorum Profundus Tendon , 2011, The Journal of the American Academy of Orthopaedic Surgeons.

[3]  W. Baer,et al.  Motion-stable flexor tendon repair with the Mantero technique in the distal part of the fingers , 2010, The Journal of hand surgery, European volume.

[4]  M. Tyllianakis,et al.  An unusual complication of Mitek suture anchor use in primary treatment of flexor digitorum profundus tendon laceration: a case report , 2009, Cases journal.

[5]  D. Dionyssiou,et al.  Anatomical Repair of Zone 1 Flexor Tendon Injuries , 2009, Plastic and reconstructive surgery.

[6]  T. Trumble,et al.  Repair of Acute Ulnar Collateral Ligament Injuries of the Thumb Metacarpophalangeal Joint: A Retrospective Comparison of Pull-Out Sutures and Bone Anchor Techniques , 2008, Plastic and reconstructive surgery.

[7]  D. Marsh,et al.  The Morbidity of the Button-over-Nail Technique for Zone 1 Flexor Tendon Repairs. Should we still be using this Technique? , 2008, The Journal of hand surgery, European volume.

[8]  Matthew J. Silva,et al.  Effect of suture material and bone quality on the mechanical properties of zone I flexor tendon-bone reattachment with bone anchors. , 2008, The Journal of hand surgery.

[9]  W. Walsh,et al.  The Effect of Mitek Anchor Insertion Angle to Attachment of FDP Avulsion Injuries , 2006, Journal of hand surgery.

[10]  T. Trumble,et al.  Comparison of pullout button versus suture anchor for zone I flexor tendon repair. , 2006, The Journal of hand surgery.

[11]  D Mass,et al.  Bone suture anchors versus the pullout button for repair of distal profundus tendon injuries: a comparison of strength in human cadaveric hands. , 2001, The Journal of hand surgery.

[12]  N. Moiemen,et al.  Primary Flexor Tendon Repair in Zone 1 , 2000, Journal of hand surgery.

[13]  D. Guinard,et al.  The Mantero Flexor Tendon Repair in Zone 1 , 1999, Journal of hand surgery.

[14]  R. F. Morgan,et al.  A new technique for the treatment of flexor digitorum profundus tendon avulsion. , 1999, Annals of plastic surgery.

[15]  D. Elliot,et al.  A New Technique of Attachment of Flexor Tendons to The Distal Phalanx without A Button Tie-Over , 1996, Journal of hand surgery.

[16]  W P Cooney,et al.  Flexor tendon forces: in vivo measurements. , 1992, The Journal of hand surgery.

[17]  P. Gerbino,et al.  Complications experienced in the rehabilitation of zone I flexor tendon injuries with dynamic traction splinting. , 1991, The Journal of hand surgery.

[18]  W. A. Eglseder,et al.  Type IV flexor digitorum profundus avulsion. , 1990, The Journal of hand surgery.

[19]  R. B. Evans.  A study of the Zone I flexor tendon injury and implications for treatment , 1990 .

[20]  W. Mcmaster,et al.  Permissible limits of flexor digitorum profundus tendon advancement--an anatomic study. , 1987, The Journal of hand surgery.

[21]  J. W. Strickland,et al.  Digital function following flexor tendon repair in Zone II: A comparison of immobilization and controlled passive motion techniques. , 1980, The Journal of hand surgery.

[22]  J. P. Leddy,et al.  Avulsion of the profundus tendon insertion in athletes. , 1977, The Journal of hand surgery.