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Results of 4-strand modified Kessler core suture and epitendinous interlocking suture followed by modified Kleinert protocol for flexor tendon repairs in Zone 2

OBJECTIVE: There has been no consensus in literature for the ideal flexor tendon repair technique. The results of zone 2 flexor tendon lacerations repaired primarily by 4 strand Modified Kessler core suture and epitendinous interlocking suture technique followed by Modified Kleinert protocol were in...

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Autores principales: Güntürk, Özgün Barış, Kayalar, Murat, Kaplan, İbrahim, Uludağ, Abuzer, Özaksar, Kemal, Keleşoğlu, Beray
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Turkish Association of Orthopaedics and Traumatology 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6204440/
https://www.ncbi.nlm.nih.gov/pubmed/30497659
http://dx.doi.org/10.1016/j.aott.2018.06.003
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author Güntürk, Özgün Barış
Kayalar, Murat
Kaplan, İbrahim
Uludağ, Abuzer
Özaksar, Kemal
Keleşoğlu, Beray
author_facet Güntürk, Özgün Barış
Kayalar, Murat
Kaplan, İbrahim
Uludağ, Abuzer
Özaksar, Kemal
Keleşoğlu, Beray
author_sort Güntürk, Özgün Barış
collection PubMed
description OBJECTIVE: There has been no consensus in literature for the ideal flexor tendon repair technique. The results of zone 2 flexor tendon lacerations repaired primarily by 4 strand Modified Kessler core suture and epitendinous interlocking suture technique followed by Modified Kleinert protocol were investigated. METHODS: 128 fingers of 89 patients who had flexor tendon laceration in zone 2 built the working group. Functional outcomes were evaluated using the Strickland formula. A statistical analysis was made between Strickland scores and some parameters such as age, gender, follow-up time, co-existing injury existence, repair time, single or multiple finger injury, tendon rupture and the effect of FDS injury and repair. RESULTS: Excellent, good, fair, poor results were obtained from 71 (55.5%), 46 (35.9%), 8 (6.3%), 3 (2.3%) fingers, respectively. Time of the repair has a significant effect on the strickland scores. Surgery performed within the first 24 hours following the injury gave better results. 3 fingers (2.3%) had tendon ruptures. Existence of ruptures affected the results significantly. Co-existing injuries were found that they did not have any effect on the results. In the fingers in which both FDP and FDS tendons were lacerated, no significant relationship was found between only FDP repair, both FDP and FDS repair and single FDS slip repair. Additionally no significant relationships between follow-up time, gender, single or multiple finger injury and Strickland scores were observed. 13 fingers (10.1%) had PIP joint contracture above 20°. CONCLUSION: The low rupture rate (2.3%) and 91.4% ‘good’ and ‘excellent’ scoring rates in our series support the idea that modified Kessler 4-strand core suture and epitendinous interlocking suture repair combined with modified Kleinert protocol gives satisfactory results. Repair time is one of the most important factors affecting the functional results and surgery should not be delayed if there is an experienced surgeon available. LEVEL OF EVIDENCE: Level IV, therapeutic study.
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spelling pubmed-62044402018-11-05 Results of 4-strand modified Kessler core suture and epitendinous interlocking suture followed by modified Kleinert protocol for flexor tendon repairs in Zone 2 Güntürk, Özgün Barış Kayalar, Murat Kaplan, İbrahim Uludağ, Abuzer Özaksar, Kemal Keleşoğlu, Beray Acta Orthop Traumatol Turc Research Paper OBJECTIVE: There has been no consensus in literature for the ideal flexor tendon repair technique. The results of zone 2 flexor tendon lacerations repaired primarily by 4 strand Modified Kessler core suture and epitendinous interlocking suture technique followed by Modified Kleinert protocol were investigated. METHODS: 128 fingers of 89 patients who had flexor tendon laceration in zone 2 built the working group. Functional outcomes were evaluated using the Strickland formula. A statistical analysis was made between Strickland scores and some parameters such as age, gender, follow-up time, co-existing injury existence, repair time, single or multiple finger injury, tendon rupture and the effect of FDS injury and repair. RESULTS: Excellent, good, fair, poor results were obtained from 71 (55.5%), 46 (35.9%), 8 (6.3%), 3 (2.3%) fingers, respectively. Time of the repair has a significant effect on the strickland scores. Surgery performed within the first 24 hours following the injury gave better results. 3 fingers (2.3%) had tendon ruptures. Existence of ruptures affected the results significantly. Co-existing injuries were found that they did not have any effect on the results. In the fingers in which both FDP and FDS tendons were lacerated, no significant relationship was found between only FDP repair, both FDP and FDS repair and single FDS slip repair. Additionally no significant relationships between follow-up time, gender, single or multiple finger injury and Strickland scores were observed. 13 fingers (10.1%) had PIP joint contracture above 20°. CONCLUSION: The low rupture rate (2.3%) and 91.4% ‘good’ and ‘excellent’ scoring rates in our series support the idea that modified Kessler 4-strand core suture and epitendinous interlocking suture repair combined with modified Kleinert protocol gives satisfactory results. Repair time is one of the most important factors affecting the functional results and surgery should not be delayed if there is an experienced surgeon available. LEVEL OF EVIDENCE: Level IV, therapeutic study. Turkish Association of Orthopaedics and Traumatology 2018-09 2018-06-29 /pmc/articles/PMC6204440/ /pubmed/30497659 http://dx.doi.org/10.1016/j.aott.2018.06.003 Text en © 2018 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B.V. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Research Paper
Güntürk, Özgün Barış
Kayalar, Murat
Kaplan, İbrahim
Uludağ, Abuzer
Özaksar, Kemal
Keleşoğlu, Beray
Results of 4-strand modified Kessler core suture and epitendinous interlocking suture followed by modified Kleinert protocol for flexor tendon repairs in Zone 2
title Results of 4-strand modified Kessler core suture and epitendinous interlocking suture followed by modified Kleinert protocol for flexor tendon repairs in Zone 2
title_full Results of 4-strand modified Kessler core suture and epitendinous interlocking suture followed by modified Kleinert protocol for flexor tendon repairs in Zone 2
title_fullStr Results of 4-strand modified Kessler core suture and epitendinous interlocking suture followed by modified Kleinert protocol for flexor tendon repairs in Zone 2
title_full_unstemmed Results of 4-strand modified Kessler core suture and epitendinous interlocking suture followed by modified Kleinert protocol for flexor tendon repairs in Zone 2
title_short Results of 4-strand modified Kessler core suture and epitendinous interlocking suture followed by modified Kleinert protocol for flexor tendon repairs in Zone 2
title_sort results of 4-strand modified kessler core suture and epitendinous interlocking suture followed by modified kleinert protocol for flexor tendon repairs in zone 2
topic Research Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6204440/
https://www.ncbi.nlm.nih.gov/pubmed/30497659
http://dx.doi.org/10.1016/j.aott.2018.06.003
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