Comparative analysis of the functional state of the hand after surgical restoration of the flexor tendons of the fingers

BACKGROUND: Surgical treatment of flexor tendon injuries is accompanied by a high level of unsatisfactory treatment results and disability. It is possible to improve the treatment results by searching for a new suture material. There is a lot of literature data on the possibility of using titanium nickelide-based materials in surgery, but there has not yet been any mention of using titanium nickelide filaments for reconstructive tendon surgery.

AIM: To carry out a comparative analysis of the results of treatment of patients with injuries to the flexor tendons of the three phalangeal fingers of the hand in the area of bone-fibrous channels using a thread made of superelastic titanium nickelide and polypropylene thread.

MATERIALS AND METHODS: An interventional, single-center, prospective, controlled, non-randomized clinical trial was conducted, which included 110 patients with damage to the tendons of the deep flexors of the fingers in the area of bone-fibrous channels. The patients were divided into two groups: the main group (n=65), which used a thread made of superelastic titanium nickelide, and the control group (n=45), which used polypropylene. The surgical intervention consisted of repairing tendons using the M-Tang technique using a 6-thread suture, the same for both groups. The follow-up lasted 12 months with control points on days 7–10, 3 weeks, 6 weeks, 3, 6 and 12 months. The main endpoint of the study was the restoration of finger function on the Fingersburg scale; the assessment was carried out by measuring active movements in the joints and comparing them with an intact finger. Additionally, grip strength, pinch strength, and DASH questionnaire scores were recorded.

RESULTS: The use of a superelastic titanium nickelide thread for suturing the tendons of the deep flexors of the fingers showed a higher frequency of excellent results (78.5%) and a significantly lower percentage of unsatisfactory outcomes (1.5%) compared with the control group (p=0.042). At the same time, the recovery of grip and pinch strength also turned out to be higher, especially in patients with incised wounds and with early surgical intervention. There were no differences in the quality of life on the DASH scale one year after treatment between the groups.

CONCLUSIONS: The results of a clinical study of the functional state of the hand after surgical repair of flexor tendons at the level of fibrous-bone channels are demonstrated, confirming the advantage of the proposed tendon suture technique by reducing the incidence of complications and improving postoperative results.