Intratendinious Versus Extracorporeal Knot Four Strand Core Suture Repair of Flexor Tendon Injuries of the Hand Zone II

Abstract

Background: Over the past few years, there has been ashift in how flexor tendons are repaired. Because of adhesionsor ruptures that occurred when early active motion was attempted,flexor tendon repairs in the digit have a long historyof producing disappointing outcomes.Objectives: To make an evaluation to the outcomes offlexor tendon repair using ordinary 4 strands suture with intratendinousknot technique and comparing it with four strandssuture with extracorporeal knot. And comparing it with our innovationtechnique; The four-strand suture with extracorporealknot.Subjects and Methods: This interventional prospective trialwas performed on persons admitted to our emergency hospitaland Burn and Plastic Surgery Center, Mansoura Universitywith flexor tendon injuries zone II from February 2020 to February2023. Patients were classified into two groups; group Atreated with the 4-strand suture with extra corporeal knot, andgroup B treated with the 4-strand suture with intra tendinousknot.Results: Statistical analysis revealed a statistically significantdistinction among the groups according to outcome, totalactive flexion (TAF) and total active range of motion (TARM)for group A, and operation time for group B. No statisticallysignificant variations were observed amongst the groupsas regard socio-demographic characteristics, injury location& dominant hand distribution among the study populations,anesthesia WALAIAT or General, follow up period, patient orparent’s satisfaction, age and outcome of treatment.Conclusion: We noticed that the four strands suture withextracorporeal knot technique for flexor tendons repair zone IIwas easy to accomplish, had a lower volume and no bulk at thesite of repair, with no suture knot inside tendon at site of repair,besides a more regular suture, that offer less interfering withtendon gliding, less adhesion formation, adequate strong repairfor an early active post-operative mobilization protocol, goodresults, good total active range of motion and good patientssatisfaction.