gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

Outcomes of FPL tendon primary repair in zone 1 and zone 2 by using M-Tang core suture followed with early active mobilization

Meeting Abstract

Search Medline for

  • presenting/speaker Zhangjun Pan - Yixing People Hospital, Jiangsu University Affiliated Yixing Hospital, Wuxi Yixing, China

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-567

doi: 10.3205/19ifssh0992, urn:nbn:de:0183-19ifssh09921

Published: February 6, 2020

© 2020 Pan.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objectives/Interrogation: We reviewed our outcomes of thumb tendon primary repair in zone 1 and zone 2 by using M-Tang core suture followed with early active mobilization in 25 patients, and evaluated the recovery of flexor pollicis longus tendon repairs by robust suture with venting pulley and early active mobilization.

Methods: From January 2014 to December 2017, we performed primary repair for completely divisions of flexor pollicis longus(FPL) tendon in zones 1 and 2 in 25 thumbs using M-Tang core suture repair followed by early active mobilization. These included 17 males and 8 females with a mean age of 39.6 (range 21 to 57) years. Three injuries were in zone 1 and twenty two in zone 2. Eighteen patients sustained injury to the right thumb and seven to the left. Twenty one thumbs had associated digital nerves and arteries injuries. We repaired FPL tendon by using M-Tang core suture with a 4-0 looped suture, followed by running peripheral suture using a 6-0 nylon suture. When the injury site was in zone 1 or the distal part of zone 2, the A2 pulley was vented entirely together with partial venting of the oblique pulley. When the injury site was at the middle or proximal parts of the zone 2, the A1 pulley was vented entirely together with partial venting of the oblique pulley. Extension-flexion test was always performed after tendon repair. Functional outcomes were evaluated with Strickland and Glogovac criteria and Tang criteria.

Results and Conclusions: A total of 25 patients were followed for a mean of 11 months (range 6 to 22) post-surgery. Among three thumbs with zone 1 injuries, two had excellent and one had a good result according to the Strickland and Glogovac criteria, and one had an excellent and two had good results according to the Tang criteria. For the 22 thumbs with zone 2 injuries, 13 had excellent, eight had good and one had fair results according to the Strickland and Glogovac criteria. Nine had excellent, 11 had good and two had fair results according to the Tang criteria. There were no FPL repair ruptures in 25 patients.

We conclude that the A1 pulley can be vented in the FPL tendon repairs in the proximal or middle parts of zone 2 and the A2 pulley and distal oblique pulley can be vented for zone 1 FPL repairs. The oblique pulley can be vented entirely or partially when necessary. Strong repair methods increase repair safety and M-Tang technique allows for safe and efficient early active rehabilitation.