COMPLICATIONS OF FLEXOR TENDON REPAIR IN THE HAND - MR-IMAGING ASSESSMENT

PURPOSE: To determine if magnetic resonance (MR) imaging enables diffe rentiation of adhesions from tendon rupture after repair of digital fl exor tendon injuries. MATERIALS AND METHODS: The reference group compr ised eight tendon sutures with a good clinical outcome. Axial and sagi ttal spin-echo sequences and three-dimensional gradient-echo sequences with curved reconstructions were analyzed in 63 injured fingers. Reop eration was performed in 41 fingers. RESULTS: MR imaging depicted isol ated peritendinous adhesions (n = 31), most often with a continuous, u niform tendon (sensitivity 91%, specificity 100%). There were two type s of rupture: frank rupture (n = 140; sensitivity 100%, specificity 10 0%) or elongated callus (n = 18; sensitivity 100%, specificity 94%). T endon gap was significantly longer in frank rupture (P = .0011). Thin fibrous continuity existed with elongated callus. Tenolysis was suffic ient when the callus was short and mature with predominant new collage n fibers. Axial spin-echo sections were essential, as they showed the maturation of the callus. CONCLUSION: MR imaging may enable-distinctio n among several complications that occur after repair of an injured di gital flexor tendon.