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CC BY-NC-ND 4.0 · Indian J Plast Surg 2021; 54(03): 338-343
DOI: 10.1055/s-0041-1734577
Original Article

Wide-Awake Approach for Flexor Digitorum Superficialis Tendon Transfer Followed by Early Active Mobilization

Takuma Kuroda
1   Niigata Hand Surgery Foundation, Niigata, Japan
2   Department of Orthopedic Surgery, Showa University School of Medicine, Tokyo, Japan
,
Koji Moriya
1   Niigata Hand Surgery Foundation, Niigata, Japan
,
Naoto Tsubokawa
1   Niigata Hand Surgery Foundation, Niigata, Japan
,
Hiroko Narisawa
1   Niigata Hand Surgery Foundation, Niigata, Japan
,
Yutaka Maki
1   Niigata Hand Surgery Foundation, Niigata, Japan
,
Katsunori Inagaki
2   Department of Orthopedic Surgery, Showa University School of Medicine, Tokyo, Japan
,
Takae Yoshizu
1   Niigata Hand Surgery Foundation, Niigata, Japan
› Author Affiliations Funding The authors received no financial support for the research, authorship, or publication of this article.
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Abstract

Background The standard clinical practice to treat closed ruptures of the flexor digitorum profundus (FDP) tendons includes free tendon grafting; however, it is not suitable when the muscle amplitude of the ruptured FDP is not sufficient. We report outcomes of six patients who underwent flexor digitorum superficialis (FDS) tendon transfer of the ring finger using the wide-awake approach to repair the closed rupture of the FDP tendon of the little finger in zone 3 or 4.

Methods The patients were identified by reviewing our institutional billing records from January 2012 to October 2019 for the International Classification of Disease 10 code M66.3 that describes the diagnosis as “spontaneous rupture of flexor tendons.”

Results The patients comprised two men and four women with an average age of 72.2 years (standard deviation [SD], 8.4 years). All patients were hospitalized after surgery to undergo early active mobilization. The average total active motion at the final evaluation was 201.8° (range: 85–248°). According to Strickland’s criteria, outcomes were excellent for two, good for three, and poor for one patient. No patients complained about the ring finger.

Conclusion These results suggest that FDS tendon transfer is recommended when the muscle amplitude of the ruptured FDP is insufficient. We believe that the wide-awake approach and early active mobilization may contribute to satisfactory outcomes.

Keywords

tendon injuries - early active mobilization - flexor digitorum superficialis - tendon transfer - wide-awake approach


Publication History

Article published online:
16 September 2021

© 2021. Association of Plastic Surgeons of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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