Non-conventional tendon advancement for injuries in Verdan zones I and II. A new surgical technique

Keywords: tendon, flexor, lengthening, Z-plasty

Abstract

Objective: To report a new surgical technique and the comparative clinical outcomes in patients with primary tenorrhaphy rupture or chronic flexor digitorum profundus (FDP) injuries in Verdan zones I and II, treated with non-conventional tendon advancement.Materials and Methods: The study population consisted of 13 patients over 18 years (averaging 29 years) who had had injuries in Verdan zones I and II and at least a 36-month follow-up. Patients were divided into two groups according to injury type (7 cases of primary tenorrhaphy rupture and 6 cases of chronic FDP injuries) and surgical technique (Z-plasty lengthening plus end-to-end suture or lateral suture to an adjacent undamaged FDP tendon at zone-V level, respectively). The results were evaluated according to Strickland’s scoring system. Results: The average follow-up was 51 months. Time period between injury and surgery averaged 11.7 weeks (range, 2-24 weeks). Strickland scoring system results: excellent in 8 patients, good in 4 patients, and poor in 1 patient. Study average tendon advancement was 20.5mm. Conclusions: Non-conventional tendon advancement for primary tenorrhaphy ruptures or chronic FDP injuries in Verdan zones I and II proved to be a reproducible and effective treatment. Key words: Tendon; flexor; lengthening; Z-plasty.Level of Evidence: III

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Author Biographies

Alberto L. Garay, Upper Limb Department, Instituto Dupuytren (Buenos Aires, Argentina)
Upper Limb Department, Instituto Dupuytren (Buenos Aires, Argentina)
Carlos E. Martínez, Upper Limb Department, Instituto Dupuytren (Buenos Aires, Argentina)
Upper Limb Department, Instituto Dupuytren (Buenos Aires, Argentina)
Juan Martín Patiño, Upper Limb Department, Instituto Dupuytren (Buenos Aires, Argentina)
Upper Limb Department, Instituto Dupuytren (Buenos Aires, Argentina)
Germán Tonetto, Upper Limb Department, Instituto Dupuytren (Buenos Aires, Argentina)
Upper Limb Department, Instituto Dupuytren (Buenos Aires, Argentina)
Francisco López Bustos, Upper Limb Department, Instituto Dupuytren (Buenos Aires, Argentina)
Upper Limb Department, Instituto Dupuytren (Buenos Aires, Argentina)

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Published
2020-11-18
How to Cite
Garay, A. L., Martínez, C. E., Patiño, J. M., Tonetto, G., & López Bustos, F. (2020). Non-conventional tendon advancement for injuries in Verdan zones I and II. A new surgical technique. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 85(4S), S12-S18. https://doi.org/10.15417/issn.1852-7434.2020.85.4S.1173