The Effect of Heparin Injection into Cut Ends of Flexor Tendon Zone II Injuries | ||||
| The Egyptian Journal of Plastic and Reconstructive Surgery | ||||
| Articles in Press, Accepted Manuscript, Available Online from 18 May 2022 | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejprs.2022.131504.1166 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
Ahmed Gadallah   1; Amir Elbarbary 2; Ahmed mohamed abd elsalam2; Noha Mohammed Gamal eldeen3; Ebrahim Mohamed Amin 4
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| 1Plastic, Burn and Maxillofacial Surgery Department, Faculty of Medicine, Ain Shams University, Cairo ,Egypt | ||||
| 2Plastic, Burn and Maxillofacial Surgery Department, Faculty of Medicine, Ain Shams University , Cairo , Egypt | ||||
| 3Diagnostic and Interventional Radiology Department, Faculty of Medicine, Ain Shams University | ||||
| 4Plastic, Burn and Maxillofacial Surgery Department, Faculty of Medicine, Ain Shams University | ||||
| Abstract | ||||
| Background: Because the FDP (flexor digitorum profundus) and the two slips of the FDS (flexor digitorum superficialis) are crowded within a tight fibro-osseous tunnel, it has never been easy to have good functional results after flexor tendon restoration in zone II, elevating the possibility of postoperative adhesions and a decrease in postoperative range of motion and power. Main aims of tendon repair are improved tendon healing and adhesion reduction. Primary flexor tendon healing methods are still being refined to this day. Aim of the Work: The goal is to assess the outcomes of heparin injection into cut ends of flexor tendon zone II injuries both clinically and radiologically using musculoskeletal ultrasound. Patients and Methods: This is an interventional clinical trial including forty individuals with flexor tendon injuries zone II. The Patients were sampled randomly into two groups, group I twenty patients (study group) with heparin injection and group II twenty patients (control group) without heparin injection. Results: Forty cases were included in our study which had zone II flexor tendon injury repaired using four strand techniques. Both groups had the same protocol of physiotherapy and follow up. Results were measured as regards the total range of motion according to Strickland criteria showing no significant change between the two groups. Heparin injection shows a higher rupture rate of flexor tendons which were injected also showing gap formation in MSK US. Also, heparin injection increases the formation of granulation tissue which negatively affects the gliding of tendon. So, heparin injection is not recommended in flexor tendon repair zone II. Conclusion: Heparin injection shows a higher rupture rate of flexor tendons which were injected also which reflect gap formation in MSK US. Also, heparin injection increases the formation of adhesive granulation tissue which negatively affects the gliding of tendon. So, heparin injection is not recommended in flexor tendon repair zone II. However, there were a few limitations to our study such as poor compliance of some patients which is considered one of the major problems that affect the post-operative outcomes Keywords: Heparin, Flexor Tendon, Zone II, Tendon rupture, Musculo skeletal ultrasound. | ||||
| Keywords | ||||
| Heparin; Flexor Tendon; Zone II; Tendon rupture; Musculo skeletal ultrasound | ||||
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