Purpose
The purpose of this study was to evaluate complications and outcomes of an all-inside
repair technique for flexor digitorum profundus (FDP) avulsions.
Methods
A retrospective review of a single institution database identified all FDP avulsions
that were repaired using an all-inside technique by a single surgeon. In this method, 2 Keith needles are drilled from the volar to dorsal aspect, exiting
proximal to the nail matrix and within the extensor tendon. Nonabsorbable sutures
were placed in the flexor tendon and passed through the bone tunnels, tying dorsally
over the distal phalanx. The demographics characteristics, injury characteristics,
the surgical procedure, postoperative complications, and outcomes were reviewed.
Results
Seventeen patients were included in the study. The average age was 40 years (range,
21–68 years), and 2 patients were women. Seventeen fingers were included: 14 ring
fingers, 1 index finger, and 2 little fingers. Six patients had an associated distal
phalanx fracture and one had an associated distal interphalangeal joint dislocation.
The average time between injury and surgery was 9 days (range, 2–18 days). Four patients
had complications: 3 with erythema related to infection, which appeared to be a reaction
to the suture prompting removal, and 1 with a subungual mass related to the suture
at removal. One patient had persistent pain. Postoperative range of motion, assessed
using the Strickland criteria, was excellent or good in 5 (33%) of 15 patients, but
this was predominantly due to motion at the proximal joints as overall DIP motion
was limited. Patients had a mean distal interphalangeal joint range of motion of 24°
(range, 0° to 55°).
Conclusions
In our series, repair of FDP avulsions via all-inside suture fixation is associated
with limited distal interphalangeal joint motion and an incidence of infection (24%)
at final follow-up.
Type of study/level of evidence
Therapeutic V.
Key words
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Compton J, Wall LB, Romans B, Goldfarb CA. Outcomes of acute repair versus nonrepair of zone i flexor digitorum profundus tendon injuries. J Hand Surg Am. Published online April 9, 2022. https://doi.org/10.1016/j.jhsa.2022.02.005
Article info
Publication history
Published online: October 03, 2022
Accepted:
August 5,
2022
Received:
April 4,
2021
Publication stage
In Press Corrected ProofFootnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Worked performed at the Department of Orthopaedics and Physical Performance, University of Rochester Medical Center, Rochester, NY.
Identification
Copyright
© 2022 by the American Society for Surgery of the Hand. All rights reserved.
