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Document Type

Original Article

Abstract

Background: Due to a variety of harmful agents, flexor tendon injuries of the hand are a problem that frequently occurs. It can sometimes be linked to phalangeal fractures and/or nerve or blood vessel injuries, which can have a significant negative impact on functional limitations and lifestyle choices. Aim of the Work: to contrast the two strands Kessler technique and the four-strand cruciate technique for the repair of flexor tendon injuries. Patients and Methods: our study included twenty patients who were divided into two groups for this prospective interventional controlled single blinded study, which was carried out at the plastic surgery trauma emergency unit and outpatient clinic at AL-Zahraa University hospital from December 2021 to January 2023. Results: Group A: excellent to good in 80% of patients (excellent 50% and good 30%), 1 fair 10% (due to an infection started 5 days post operatively that delayed the start of the rehabilitation protocol) and 1 poor 10% (due to adhesions post operatively). Group B: excellent to good in 70 % of patients (excellent 30% and good 70%), 1 fair 10% (due to skin contracture) and 2 recorded as poor (due to adhesions). Despite the overall results, but there was a significance difference in favor of Group A regarding the quality of motion i.e. motion arc, coordination and speed. Group A: 70% of patients had excellent quality of motion compared to only 20% in Group (B), While 10% recorded as poor in Group (A) compared to 60% in Group (B). Conclusion: In terms of motion range, grip strength, the zone of injury, and the likelihood of complications, this study indicates that flexor tendon injuries can be successfully managed by either two or four strands repair techniques. However, using a four-strand locked cruciate instead of a two-strand Kessler, then starting early postoperative controlled active rehabilitation will lead to a better functional outcome, particularly in terms of motion quality, such as motion arc, coordination, and speed.

Keywords

Four Strands Cruciate; Strands Kessler; flexor tendon injuries

Subject Area

Plastic surgery

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