Secondary flexor tendon reconstructions - how good are they?

Abstract

Secondary reconstructions of flexor tendons are nowadays seldom - due to developments in primary repairs of flexor tendon. They are however indicated in complex cases. The results of a tertiary, supraregionally operating hand centre are presented. The results are compared with recent and historic published results. During a period of 11 years and with a total of 644 flexor tendon repairs, there have been 52 secondary flexor tendon reconstructions: 7 single staged reconstructions, 16 tendon transpositions and 29 two staged reconstructions. A total of 39 patients have been evaluated retrospectively using the system of Buck-Gramcko. Excellent to good results have been achieved in 60 % of the single staged reconstructions. Functional = excellent to good results are found in 75 % of the transpositions. 50 % of the two staged reconstructions obtained a functional result. In total 58.5 % of the secondary flexor tendon reconstructions achieved a functional result according to the system of Buck-Gramcko. Secondary flexor tendon reconstructions make up about 7.5 % of all flexor tendon injuries. The functional results have changed little during the last decades and relevant improvement appears to be impossible. In comparison to primary suture of flexor tendons, the results are disappointing. The objective is to further optimize the primary repair of flexor tendons and consequently to reduce the need for secondary reconstructions.