Reconstruction of Tendon Sheath by a Vein Graft in Flexor Tendon Repair in Adjacent Digits

Abstract

Background: Adhesion formation after tendon injury isa challenging clinical problem.Aim: We compare the outcome of reconstructing the flexortendon sheath after primary flexor tendon repair using anautogenous vein graft to reduce post-operative peritendiniousadhesions.Methods: Eight patients have acute flexor tendon injuriesof both FDS and FDP in zone II in more than one digit.Primary tenorrhaphy was done using traditional technique.In one-digit vein graft was used to reconstruct tendon sheathwindow, while in the other digit, the tendon sheath leftuntreated. Post-operative physiotherapy program of controlledactive motion is used for both group. All patients were assessedusing the second Buck-Gramcko scale at 2 and 6 months.Results: For the vein graft group, 2 patient had excellentresult, 2 had very good, and 4 patients had good result. Ingroup II, 2 patients had very good result, 2 patients had goodresult, and 4 patients had fair result.Conclusion: The use of autologous vein graft as a substituteof tendon sheath is a good treatment modality. Compared toconventional tendon repair technique, it was associated withless adhesion formation and less joint contracture.Evidence Based Medicine: Level IV, vase series.