Article
A case series exploring outcomes of unrepaired zone 1 flexor tendon injuries
Search Medline for
Authors
-
Trish Griffiths
- The Hand Rehabilitation Unit, Cape Town Sports & Orthopaedic Clinic, Netcare Chrsitiaan Barnard Memorial Hospital, Cape Town, South Africa
-
Shahra Sattar
- The Hand Rehabilitation Unit, Cape Town Sports & Orthopaedic Clinic, Netcare Chrsitiaan Barnard Memorial Hospital, Cape Town, South Africa
| Published: | February 6, 2020 |
|---|
Outline
Text
Objective: A case-series describing outcomes of unrepaired zone 1 flexor tendon injuries (FTIs) in a tertiary hospital hand clinic in Cape Town, South Africa. The case-series is informed by the assumption that non-repair does not significantly affect function post injury. There is a lack of literature regarding outcomes of unrepaired FTIs as the default management is surgical repair. There is a lack of literature from a patient perspective in flexor tendon research, and the activity and participation domains of the International Classification of Function are underrepresented.
Materials and Methods: Adult patients diagnosed with zone 1 FTI who did not have surgical repair between March 2014 and January 2017 were eligible. Assessments occurred more than a year post injury. The four patients who consented, were interviewed and assessed using the following observation tools and self-reported questionnaires:
- 1.
- ROM: goniometry to work out the Total Active Motion (TAM)
- 2.
- Grip and tripod pinch strength using a calibrated dynamometer
- 3.
- Dexterity: MODAPTS test 4,6,7 and 8
- 4.
- Satisfaction: satisfaction section of the Michigan Hand Questionnaire
- 5.
- Activity and participation: QuickDASH questionnaire
- 6.
- Time taken to return to work
Results: One participant developed a flail joint. All participants had high TAM scores with good PIPJ and MCPJ ROM. 3 participants had grip strength scores below norms but 2 of these are considered functional. 3 tripod pinch strength results are considered functional despite being below their norms. MODAPTS results were variable. Satisfaction scores ranged between 71.6% and 98%. QuickDASH scores ranged between 2.3 and 27.3.
Conclusions: Non-repair is considered a viable treatment option for this population as satisfaction scores were high, return to work timescales were favourable, time off work and income loss is reduced; common compliance issues are negated and surgical costs and numerous post-operative complications are avoided.
