Study of the Repair of Flexor Tendons of the Hand

Study Overview
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Brief Summary
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Injury to the flexor tendons of the fingers of the hand is a frequent and disabling injury, since it produces tendon retraction and functional limitation. A prompt and adequate diagnosis and treatment is required to minimize the risk of tendon retraction, re-rupture, reoperation rate, and the presence of tendon adhesions that limit the range of motion. On occasions, the limitation of the articular balance of the MCP, PIP and DIP joints generates a loss of strength and difficult in completely closing the fingers to the palm of the hand.

Detailed Description
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To retrospectively evaluate the results obtained with the suture/ reinsertion of the flexor tendons of the hand, in the acute, subacute and chronic phases, treated surgically in our center between the years 2000 and 2021. To evaluate the clinical and functional results obtained in patients who underwent surgery for a section of the flexor tendons, superficial, profundus or both, preferably in zone II of the hand. The investigators evaluate the epidemiological and prognostic factors associated with the injury, in the different phases and anatomical zones. The researchers evaluate the functional results: Pain at rest with movements: Assessed using the visual analogue pain scale (VAS Scale from 0 to 10). Joint balance / Range of motion of the MCP, PIP, DIP joints. Evaluation by digital goniometer. Evaluation using Buck-Gramcko (1976) and using the Tang (2007) criteria. Grip strength. Evaluation using a Jamar dynamometer. Functional rating scales: QuickDASH Score Reoperation rate: 1) For re-rupture / re-suture, 2) For infection, 3) For excision of tendon adhesions: arthrolysis and tendolysis, 4) For tendon transfer 5) For tendon graft placement.

Official Title
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Study of the Repair of Flexor Tendons of the Hand: Epidemiological and Prognostic Factors Associated With Tendon Injuries in Zone II

Conditions
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Tendon Injury - Hand

Intervention / Treatment
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* Procedure: Repair: suture, reinsertion, tendon graft, surgery in two stages (Hunter, Paneva Holevich)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with section of the superficial and / or profundus flexor tendons in the hand. Patients with section of the flexor tendon in the thumb Tendon injury in any anatomical area In the acute, subacute or chronic phases of the disease Associated or not with fractures Associated or not with arterial or nerve injuries Exclusion Criteria: Previous bone disease History of tendon injury to the extensor or flexor tendons Joint stiffness prior to tendon section Rheumatic arthropathy History of operations in the same area.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 85 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Procedure: Repair: suture, reinsertion, tendon graft, surgery in two stages (Hunter, Paneva Holevich)|Repair tendon flexor sections in the hand: Suture, reinsertion, tendon graft, surgery in two stages (Hunter, Paneva Holevich). The surgery depends on the anatomical area of the tendon section and the time between the injury and the operation.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Range of motion (ROM) | Change in the mobility of the MCP, PIP and DIP joints. Evaluation with goniometer (cm) | 12 months | 
| Grip Strength | Change of strength with respect to the contralateral hand. Evaluation with Jamar Dinamometer (Kg) | 12 months | 
| Chronic residual pain | Evaluation residual pain at rest and with activity with the Visual Analogue Scale (values from 0 to 10; 0 is the better outcome and 10 is the worse outcome). | 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Epidemiological variables age, sex, smoker, diabetes, heart disease, other diseases (lung, kidney, etc.). | Evaluacion of epidemiological factors associated with outcomes in flexor injuries. | 12 months | 
| Trauma variables | Affected finger, dominant hand, involvement of one or more fingers, type of injury (complete / partial section / association with fractures /association with arterial injury/ association with nerve injury/ section only FP or section FS plus FP). | 12 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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tendon, flexor, hand