gms | German Medical Science

Objectives/Interrogation: We retrospectively reported the outcomes of flexor tendon repairs in zone 2 under wide-awake local anesthesia no tourniquet.

Methods: From January 2015 to October 2017, we performed primary or delayed primary repair for completely divisions of flexor digitorum profundus (FDP) tendon in zone 2 in 23 fingers (20 patients) under wide-awake local anesthesia no tourniquet. We repaired the FDP tendons using 6-strand M-Tang core suture with 4-0 looped sutures, followed by a running peripheral suture using a 6-0 nylon suture. A digital active extension-flexion test was performed during the operation after tendon repair to determine the strength of tendon repair and the venting extent of A4 pulley or A2 pulley. Active partial range flexion exercise were initiated from day 3 to 5 after surgery during early active mobilization. The outcomes were evaluated with Strickland criteria and Tang criteria.

Results: A total of 23 fingers were followed up more than 6 months (mean 10 months). By the Strickland criteria, 15 had excellent, 5 had good, 2 fair, and 1 had poor results. According to Tang criteria, excellent and good function was achieved in 9 and 10 fingers, fair in 2 and poor in 2 fingers at the final follow-up, respectively. No repaired tendon had rupture.

Conclusion: We conclude that flexor tendon repair in zone 2 under wide-awake local anesthesia no tourniquet yields good outcomes.