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CC BY 4.0 · Rev Bras Ortop (Sao Paulo) 2024; 59(01): e60-e67
DOI: 10.1055/s-0044-1779332
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Minimally Invasive Suture Technique Pull-out to Repair the Acute Flexor Tendons in Zone II of the Hand

Article in several languages: português | English
João Carlos Belloti
1   Departamento de Ortopedia e Traumatologia, Universidade Federal de São Paulo, São Paulo, SP, Brasil
,
Luis Antonio Buendia 
2   Departamento de Ortopedia e Traumatologia, Hospital Municipal Carmino Caricchio, São Paulo, SP, Brasil
3   Departamento de Ortopedia e Traumatologia, Hospital Samaritano de São Paulo, São Paulo, SP, Brasil
,
Marcel Jun Tamaoki
1   Departamento de Ortopedia e Traumatologia, Universidade Federal de São Paulo, São Paulo, SP, Brasil
,
João Batista Gomes dos Santos
1   Departamento de Ortopedia e Traumatologia, Universidade Federal de São Paulo, São Paulo, SP, Brasil
,
Flávio Falopa
1   Departamento de Ortopedia e Traumatologia, Universidade Federal de São Paulo, São Paulo, SP, Brasil
,
Heitor José Rizardo Ulson
3   Departamento de Ortopedia e Traumatologia, Hospital Samaritano de São Paulo, São Paulo, SP, Brasil
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Financial Support This research did not receive any specific funding from public, commercial, or non-profit sector funding agencies profitable.
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Abstract

Objective: To evaluate the safety and effectiveness of a modified pull-out suture technique in patients undergoing primary repair surgery for injuries to the flexor tendons of the fingers with Total Active Motion (TAM) as the primary outcome.

Method: A total of 29 patients (38 fingers) were chosen from both sexes, aged between 18 and 65 years with clean acute tendon laceration occurring within 15 days, in the Verdan's zone II of flexor tendon in the hand, when only the deep flexor tendon was sutured, either associated or not with digital nerve injury. The patients were operated on using the proposed technique and evaluated at 3, 9 and 24-weeks PO. The primary outcome was the assessment of Total Active Movement (TAM) and 3 classifications were employed: Strickland, IFSSH and Buck-Gramcko.

Results: We observed a total active motion (TAM) of 209.3 °at the end of 24 weeks; 83.0% of Good and Excellent results by the Modified Strickland Classification, 93% of Excellent results by the IFSSH Classification, and 97% of Good and Excellent results using the Buck-Gramcko Classification. There were no cases of rupture, but tendon adhesion was observed in 3 fingers.

Conclusion: The present suture technique proved to be safe and effective with a low rate of complications, obtaining an excellent functional result in terms of total active mobility, according to the evaluations and classifications used.

Keywords

tendon injuries - rupture - suture

Work developed at the Department of Orthopedics and Traumatology, Hospital Municipal Carmino Caricchio, São Paulo, SP, Brazil.




Publication History

Received: 14 March 2023

Accepted: 10 August 2023

Article published online:
21 March 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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