Effect of Time to Hand Therapy Following Zone II Flexor Tendon Repair

Overview

Journal Plast Reconstr Surg Glob Open

Specialty General Surgery

Date 2021 Jan 11

PMID 33425592

Citations 3

Authors

Shepard P Johnson

Brian P Kelley

Jennifer F Waljee

Kevin C Chung

Affiliations

Soon will be listed here.

Abstract

Methods: Insurance claims from the Truven MarketScan Databases were used to evaluate outcomes after isolated zone II flexor tendon repairs between January 2009 and October 2015. Cohorts differing in time to hand therapy were compared to evaluate the impact on complications, reoperation, and number of therapy sessions. Secondary outcomes analyzed how the number of therapy sessions affected rates of reoperation.

Results: Hand therapy was identified in 82% of patients (N = 2867) following tendon reconstruction. Therapy initiation occurred within 1 week, 1-4 weeks, and after 4 weeks in 56%, 35%, and 9% of patients, respectively. Univariate analysis showed no difference in non-tendinous complications (27%, 30%, 29%; = 0.29) or tendon rupture rates (13%, 13%, 10%; = 0.42) within 90 days between cohorts. Multivariable analysis showed no difference in rates of tenolysis (6.3%, 6%, 4.4%; > 0.01). In the early initiation cohort, >23 hand therapy sessions were associated with the highest rates of tenolysis (19%).

Conclusions: Despite being a common fear of hand surgeons, early initiation of hand therapy was not associated with increased tendon rupture rates. Although delayed therapy is a concern for tendon scarring, it did not confer a higher risk of tenolysis. Complication rates do not appear to correlate with timing of hand therapy. Therefore, hand surgeons should promote early mobility following isolated flexor tendon injuries given the known functional outcome benefits.

Citing Articles

Maximizing hand function following zone II flexor tendon repair: A systematic review and meta-analysis of rehabilitation strategies.

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Mesenchymal Stromal Cells for the Enhancement of Surgical Flexor Tendon Repair in Animal Models: A Systematic Review and Meta-Analysis.

Epanomeritakis I, Eleftheriou A, Economou A, Lu V, Khan W Bioengineering (Basel). 2024; 11(7).

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Revision of Flexor Tendon Repair: Factors Associated With Flexor Tenolysis.

Demers A, Moran T, Bustos F, Forster G, Natal E, DeGeorge Jr B Hand (N Y). 2022; 19(4):664-670.

PMID: 36564984 PMC: 11141425. DOI: 10.1177/15589447221142890.

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