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Outcomes of Surgical Repairs Performed Within 3 Days of Sustaining Acute Traumatic Flexor Tendon Injuries
Stephen H Colbert, MD
University of Missouri, Columbia, MO
Introduction: Our objective was to determine if surgical repair of flexor tendon injuries within 3 days was associated with improved patient outcomes.
Materials & Methods: A retrospective IRB-approved analysis was performed for 553 patients who sustained flexor tendon injuries from a single institution from 2009-2023. Included patients all sustained acute traumatic flexor tendon injuries with mapping of flexor tendon zones. Patients were stratified by those who sustained flexor tendon injuries with surgical repairs performed ?3 days and surgical repairs performed >3 days. Univariate analysis, followed by stepwise multivariate logistic regression analysis using forward selection was used to identify independent predictors. Median follow-up was 12.9 weeks (range:0-534).
Results: Of the 553 patients who sustained traumatic flexor tendon injuries, 198 patients had surgical repairs performed ?3 days and 355 patients had surgical repairs performed >3 days. Earlier repair was associated with less stiffness (41.9% vs. 53.2%; p=0.015), contracture (8.5% vs. 16.9%; p=0.008), and tendon rupture (2.5% vs. 6.7%; p=0.035). Patients with tendon repairs performed ?3 days were more likely to have arterial injury (OR: 2.4, 95%CI: 1.5-3.8; p<0.001) and more likely to have anemia (OR: 2.1, 95%CI: 1.03-4.2; p=0.039) than tendon repairs performed >3 days. Patients with tendon repairs performed ?3 days were less likely to develop stiffness (OR: 0.6, 95%CI: 0.4-0.9; p=0.015) than tendon repairs performed >3 days.
Conclusions: Tendon repairs for acute traumatic flexor tendon injuries performed ?3 days were predictive of lower rates of stiffness compared to tendon repairs performed >3 days at final follow up. There were no negative findings when flexor tendon repairs were performed earlier than later.
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