Zone II Thumb Flexor Tendon Repair: A Functional Outcome Report
El Gazzar, K., Gad, A., amr, A. (2022). Zone II Thumb Flexor Tendon Repair: A Functional Outcome Report. EKB Journal Management System, 46(4), 323-331. doi: 10.21608/ejprs.2022.269070
Khaled El Gazzar; Ahmed Mohamed Gad; Adel Hussein amr. "Zone II Thumb Flexor Tendon Repair: A Functional Outcome Report". EKB Journal Management System, 46, 4, 2022, 323-331. doi: 10.21608/ejprs.2022.269070
El Gazzar, K., Gad, A., amr, A. (2022). 'Zone II Thumb Flexor Tendon Repair: A Functional Outcome Report', EKB Journal Management System, 46(4), pp. 323-331. doi: 10.21608/ejprs.2022.269070
El Gazzar, K., Gad, A., amr, A. Zone II Thumb Flexor Tendon Repair: A Functional Outcome Report. EKB Journal Management System, 2022; 46(4): 323-331. doi: 10.21608/ejprs.2022.269070

Zone II Thumb Flexor Tendon Repair: A Functional Outcome Report

The Egyptian Journal of Plastic and Reconstructive Surgery
Article 2, Volume 46, Issue 4, November 2022, Page 323-331  XML PDF (19.45 MB)
Document Type: Original Article
DOI: 10.21608/ejprs.2022.269070
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Authors
Khaled El Gazzar* ; Ahmed Mohamed Gad; Adel Hussein amr
The Department of Plastic, Reconstructive and Maxillofacial Surgery, Faculty of Medicine, Ain Shams University
Abstract
Background: Although the utmost importance of the thumb
to hand biomechanics, the reports discussing thumb flexor
tendon repair are few if compared to other digits. A reliable
report for flexor tendon repair should include a standard
surgical technique, rehabilitation and evaluation protocols,
and the outcomes in correlation to the surgeons' level of
expertise. We report our experience in management of flexor
pollicis longus (FPL) tendon injuries at zone II.
Patients and Methods: Between 2015 and 2022, a retrospective
study included 26 patients with zone II FPL tendon
injuries were included. By using a goniometer, the percent of
the total active range of motion in comparison to the contralateral
thumb was assessed and graded according to Tang
criteria of assessment.
Results: The follow-up period ranged from 7 to 28 months
with average 10.5 months. The total active thumb range of
motion was graded excellent in 15.3% (n=4), good in 42.3%
(n=11), fair in 30.7 (n=8), poor in 11.5% (n=3), and zero
incidence of tendon rupture. The only documented major
complication was poor functional outcome that needed a
session of tenolysis. The remaining of the complications were
managed conservatively. The zone V retrieval incision showed
the least functional outcome and were used in 8 patients.
Seven out of the 8 patients were graded as poor to fair and
only one patient was graded as good. Among 20 repairs done
by level 4 surgeons, 60% (n=12) of patients showed excellent
to good functional outcome grading, and 25% (n=5) incidence
of minor complications. Among 6 repairs done by level 3
surgeons, only 50% (n=3) of patients showed excellent to
good functional outcome grading, and 33% (n=2) incidence
of complications, one was major complication that needed
another session of tenolysis.
Conclusion: In consideration to its importance, more
studies should be directed to report the FPL tendon injuries.
The reports including the surgeons' level of expertise are more
informative and reliable for interpretation of the functional
outcome.
Keywords
Thumb; Flexor tendon; Zone II repair
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