ORIGINAL RESEARCH
Two-stage repair of finger flexor tendons in children with chronic tendon ruptures in fibro-synovial canals
1 N. F. Filatov Children’s Municipal Clinical Hospital No. 13, Moscow, Russia
2 Pirogov Russian National Research Medical University, Moscow, Russia
Correspondence should be addressed: Alexander Alexandrov
ul. Sadovaya–Kudrinskaya, d. 15, Moscow, Russia, 123001; ur.liam@grusorcimxela
Two-stage repair is a well-developed method that is commonly used to repair chronic ruptures of flexor digitorum profundus tendons. However, its use in pediatric hand surgery is limited due to the absence of tendon implants adapted for children. The article describes a modified Paneva-Holevich/Hunter technique for two-stage tendon reconstruction using original, oval, Lavsan-reinforced silicone prosthetic implants of four sizes (depending on patients’ age). The surgery was performed in 34 children aged 1.5–17 years. Long-term outcomes were assessed in 12 patients (8 boys and 4 girls) using the Total Active Motion scale. The follow-up period was 30 months. The average active range of motion accounted for 178.8° in boys and 218.8° in girls. The results of treatment (TAM %) were considered good in all the girls (average score of 84.3 %), and in those boys who received surgery for fingers IV and V (average score of 80.0 %). The boys who received tendon repair for fingers II and III had “good” and “poor” results (average score of 67.0 %). The proposed method of two-stage tendon repair of chronic tendon ruptures in fibro-synovial channels in children was shown to provide good results with minimal complication rates and acceptable donor site deficiency.
Keywords: two-stage tendon repair, tendon silicone prosthetic implants, tendons of flexor digitorum profundus, chronic ruptures