Outcomes of the 6-Strand M-Tang Repair for Zone 2 Primary Flexor Tendon Repair in 45 Digits

Abstract

Objective: To report the clinical and functional outcomes of our patients with complete divisions of flexor tendons in zone 2 using a 6-strand core M-Tang repair method and partial early active motion protocol and examines the possible factors affecting the functional outcomes. Materials and Methods: We conducted a retrospective review of all patients who underwent flexor tendon in zone 2 of digits repair from November 2013 to July 2015 by a single surgeon in our department. A total of 45 digits (8 thumbs and 37 fingers) in 36 consecutive patients (9 females and 27 males) with complete divisions of flexor digitorum profundus (FDP) tendon, with or without concomitant flexor digitorum superficialis (FDS) lacerations in zone 2 of digits were included. We repaired flexor tendons in zone 2 using a 6-strand core M-Tang repair method using two groups of looped nylon sutures and partial early active motion protocol starting from postoperative day 4. We analyzed the different excellent and good rates of digits of different variables using the Fisher discriminate analysis. Results: The patients were followed for 7 to 18 months after surgery, and functional outcomes were evaluated with Strickland criteria. The recovery of function was excellent in 31 (68.9%), good in 8 (17.8%), and fair in 6 (13.3%) digits. There were no repair ruptures. No bowstringing was found in the fingers after venting of a part of the A2 pulley during follow-up. No significant differences were observed in the excellent/good rate among all different digits. However, we found that the recovery outcome of male patient was greater than female patient ( P, .002). Conclusions: We conclude that the 6-strand M-Tang core repair combined with partial early active motion is safe, and outcomes of the repair are generally good or excellent when surgeons and therapist follow the surgical and rehabilitation guidelines.