New materials, techniques of tendon suture and methods of post-operative rehabilitation offer surgeons perspective of effective repair and excellent outcomes. Results of experimental studies show that multistrand tendon suture provides better mechanical properties than two-strand technique, however, clinical use in only 4 studies did not confirm its definitive superiority to traditional method of the repair.
<bold>The aim of the study</bold> was the assessment of the outcomes of the treatment of flexor tendon repair by a modified, four-strand Stickland technique.
<bold>Material and methods.</bold> Flexor tendons lacerations in 60 patients, all in Verdan's zone II, without associated bone fractures and impaired blood supply were repaired by a modified, four-strand Stickland technique. An active flexion and extension of the fingers in the range restricted by a splint was recommended immediately after operation. Early results were evaluated in 51 patients, 41 men and 10 women, in a mean age of 31 years, in whom 69 tendons were repaired in 69 digits. Follow-up at 2 and 6 weeks included examination of total active range of motion (AROM) of involved fingers, rupture rate and complications.
<bold>Results.</bold> Failure of the repair occurred in 3 cases (6%), including one thumb, index and little finger, all between 2nd and 6th week after the operation. A mean AROM at 2 and 6 weeks was 38% and 58% of the normal value (270° for the finger and for 170° the thumb), respectively. In 13 digits (28%) AROM at 6 weeks was excellent, greater than 80%, but in 5 digits was poor, less than 20% of the normal value. The main cause of reduced AROM was incomplete extension of the digits, due to splint employment up to 6 weeks post-operatively.
<bold>Conclusions.</bold> Early results obtained in the study fail to confirm greater endurance of four-strand repair over two-strand, what suggest rupture rate closed to given in the literature. An active range of motion achieved in the group was poorer than obtained after two-strand repair in other studies, but one can expect its improvement in the longer perspective.
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