FLEXOR TENDON GRAFT FOR LATE MANAGEMENT OF ISOLATED RUPTURE OF THE PROFUNDUS TENDON

Background: Late management options for the neglected flexor tendon in jury include arthrodesis, tenodesis, tendon advancement, or tendon gra fting. Although the clinical outcomes of single-stage and second-stage flexor tendon grafting are satisfactory, many controversies exist, Th e present study retrospectively reviewed the clinical outcomes of flex or tendon grafting for 15 patients with isolated profundus rupture. Me thods: Fifteen cases of isolated rupture of the flexor profundus tendo n were treated by free tendon graft, The age of the patients ranged fr om 13 to 21 years (mean, 17.3 years), The time from injury to operatio n ranged from 4 to 14 weeks (mean, 8.3 weeks), 11 tendon grafts were p assed through the intact superficialis tendon to repair the injured pr ofundus tendon, These patient were followed up from 14 to 62 months af ter treatment (mean, 31.3 months). Results: All but one patient had le ss than 3.2 cm of flexion from fingertip to mid-palmar crease, Fourtee n patients achieved active distal interphalangeal (DIP) joint flexion of more than 20 degrees, Four patients developed extension loss of the proximal interphalangeal (PIP) joint of more than 30 degrees after su rgery, The mean active flexion after surgery was 33 degrees (range, 15 -55 degrees) for DIP joints and 91.3 degrees (range, 80-100 degrees) f or PLP joints, Three patients had combined extension loss of PIP and D IP joints of more than 40 degrees for the index and middle fingers. Tw elve patients (80%) had satisfactory results, whereas treatment of the other 3 patients was considered unsuccessful. Conclusion: Flexor tend on graft can be used to reconstruct the isolated rupture of the profun dus tendon and achieve satisfactory results for properly selected pati ents.