Article
Rupture rate, functional outcome and patient satisfaction after primary flexor tendon repair using the Arthrex FiberLoop® and Tsuge suture technique with early active motion rehabilitation
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Published: | February 6, 2020 |
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Objectives/Interrogation: While the current literature in flexor tendon repair primarily supports a 4-strand locking core suture and epitendinous repair, the optimal suture material remains unclear. Identifying the ideal suture material could help provide sufficient stability for early dynamic splint therapy and thus improve total active motion (TAM), grip strength and daily activities. We hypothesize the rupture rate after flexor tendon repair with the Arthrex FiberLoop® (Arthrex, Munich, Germany) is lower than other suture materials and functional outcome and patient satisfaction are superior compared to the current literature.
Methods: A 2-stage retrospective, randomized follow-up study of 143 patients treated with the Arthrex FiberLoop® after flexor tendon injury in zones 2 or 3 from May 2013 - May 2017 was performed. In the 1st stage, the rupture rate in all patients was assessed after a follow-up of >1 year to exclude revision surgery. In the 2nd stage, 20% patients (29 patients) were randomly clinically examined. Functional parameters, such as finger and wrist mobility measured with a goniometer, grip strength measured with a Jamar dynamometer, patient satisfaction measured using school grades (1-6), pain-levels measured using visual analogue scales (0-10), and DASH-score were assessed. The Buck-Gramcko and Strickland scores were calculated to compare our results to the current literature.
Results and Conclusions: A rupture rate of 2.1% was recorded. A postoperative complication was reduced TAM. 29 patients (20% of all patients) were examined at a mean of 34 ± 7.5 months postoperatively. 10.3% of these patients had an incomplete fingertip palmar distance. Postoperative grip strength was on average 24 ± 3.1 kg. 93.0% of these patients were very satisfied with treatment. No patient complained of pain postoperatively. The mean postoperative DASH score was 6.7 ± 2.8 points. The mean Buck-Gramcko score was 14 ± 0.2 points. According to the Strickland score, 93.0% patients had excellent and 6.99% good results. Patients returned to work at a mean of 4 ± 0.7 months postoperatively.