Flexor pollicis longus tendon retrieval using silicone rods; is it worth it?

Abstract

The hand represents one of the most common sites for injuries in a trauma setting. Hand mobility, the arc of motion away from the body, and being involved in many of the daily activities add to this high incidence. Thumb injuries carry a substantial burden on hand function due to its mobility, distinctive motion patterns, and particular purposes it attains. This is a prospective case-control study for cases presented to the emergency department at Kasr Al-Ainy, school of medicine, Cairo University, for the period between January 2018 and July 2019, with zone II (T2) flexor pollicis longus (FPL) tendon injuries. Patients were divided into two groups: one group had FPL retrieved with the aid of silicone rods using a different wrist incision and the other group had a retrieval done through the same site of injury without the use of rods. Patients were followed up paying attention to their rehabilitation progress, return-to-work time, and complications (e.g., rupture and infections). Patients with comorbidities (e.g., diabetes mellitus), hand infections, or associated fractures were excluded from the study. One hundred patients were included in this study. Randomly, 50 patients were assigned to group A and 50 patients to group B. The age range was 16 to 75 years. Eighty percent of the patients were males, and the remaining 20% were females. Follow-up period ranged from 3 months to 1 year with a mean follow-up period of 8 months. Group A showed shorter operative time (P value < 0.001), faster return to work (P value < 0.001), and lower complication rates (P value < 0.07) than group B. The use of silicone rods represents a suitable method for FPL tendon repair with faster recovery, lower complication rates, and shorter operative times. Level of evidence: Level IV, therapeutic study.