Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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Loop Suture Technique for Flexor Digitorum Profundus Tendon Repair in the Insertion Site

고리 봉합법을 이용한 심부 수지 굴건 종지부에서의 건봉합

  • Lee, Kyu-Cheol (Department of Plastic and Reconstructive Surgery, Kwangmyung Sung-Ae General Hospital) ;
  • Lee, Dong-Chul (Department of Plastic and Reconstructive Surgery, Kwangmyung Sung-Ae General Hospital) ;
  • Kim, Jin-Soo (Department of Plastic and Reconstructive Surgery, Kwangmyung Sung-Ae General Hospital) ;
  • Ki, Sae-Hwi (Department of Plastic and Reconstructive Surgery, Kwangmyung Sung-Ae General Hospital) ;
  • Roh, Si-Young (Department of Plastic and Reconstructive Surgery, Kwangmyung Sung-Ae General Hospital) ;
  • Yang, Jae-Won (Department of Plastic and Reconstructive Surgery, Kwangmyung Sung-Ae General Hospital)
  • 이규철 (광명성애병원 성형외과) ;
  • 이동철 (광명성애병원 성형외과) ;
  • 김진수 (광명성애병원 성형외과) ;
  • 기세휘 (광명성애병원 성형외과) ;
  • 노시영 (광명성애병원 성형외과) ;
  • 양재원 (광명성애병원 성형외과)
  • Received : 2010.04.14
  • Accepted : 2010.07.08
  • Published : 2010.09.10
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Abstract

Purpose: In the case of repair for far distal parts of FDP (Flexor digitorum profundus) division, the method of either pull-out suture or fixation of tendon to the distal phalanx is preferred. In this paper, the results of a modified loop suture technique used for the complete division of FDP from both zone 1a and distal parts of zone 1b in Moiemen classification are presented. Methods: From July 2006 to July 2009, the modified loop suture technique was used for the 10 cases of FDP in complete division from zone 1a and distal parts of zone 1b, especially where insertion sites were less than 1 cm apart from a tendon of a stump. In a suture technique, a loop is applied to each distal and proximal parts of tendon respectively. Core suture of 2-strand and epitendinous suture are done with PDS 4-0. Out of 10 patients, the study was done on 6 patients who were available for the followup. The average age of the patients was 49.1 years (in the range from 26 to 67). 5 males and 1 female patients were involved in this study. There were 3 cases with zone 1a and distal parts of zone 1b. The average distance to the distal tendon end was 0.6 cm. There were 5 cases underwent microsurgical repair where both artery and nerve divided. One case of only tendon displacement was presented. The dorsal protective splint was kept for 5 weeks on average. The results of the following tests were measured: active & passive range of motion, grip strength test, key pinch and pulp pinch test. Results: The follow-up period on average was 11 months, in the range from 2 to 20 months. There was no case of re-rupture, but tenolysis was performed in 1 cases. In all 6 cases, the average active range of motion of distal interphalangeal joint was 50.8 degree. The grip strength (ipsilateral/contralateral) was measured as 88.7% and the pulp pinch test was 79.2% as those of contralateral side. Flexion contracture was presented in 2 cases (15 degree on average) and there was no quadrigia effect found. Conclusion: Despite short length of tendon from the insertion site in FDS rupture in zone 1a and distal parts of zone 1b, sufficient functional recovery could be expected with the tendon to tendon repair using the modified loop suture technique.

Keywords

References

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