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Trauma

THE AUDIT CYCLE IN TREATMENT OF FLEXOR TENDON INJURIES IN 112 PATIENTS AT A SPECIALIST HAND CENTRE

European Federation of National Associations of Orthopaedics and Traumatology (EFORT) - 12th Congress



Abstract

Introduction

Flexor tendon injuries are quite common injuries. They can result in persisting functional deficit if not repaired and appropriately rehabilitated. We look at flexor tendon injuries over a period of 1 year and re-audited three years later.

Method

We audited all flexor tendon injuries that were treated at our institution and repeated the same audit three years after. We looked at various aspects of the injuries including the site injured, the zone of injury, other structures injured, the type of repair and material used as well as the rehabilitation regime.

Results

The initial audit had 43 patients, 83% male, 55% unemployed with 85 tendon injuries. There were 35% zone 5 injuries with 34% repaired in <24hrs with modified Kessler core 3.0 prolene sutures and 6.0 prolene peripheral sutures. The rupture rate was 3% and the infection rate was 1%.

A re-audited was done 3 years later, over the same time period, there were 69 patients, 83% male, 1% unemployed with 102 tendon injuries. There were 40% zone 2 injuries with 43% repaired with modified Kessler core 3.0 prolene sutures and 6.0 prolene peripheral sutures. Rupture rate was 9% and infection rate was 1% and 10% median nerve injury. All injuries were rehabilitated using the Belfast regime.

Discussion and Conclusion

Flexor tendon injuries are frequently occurring injuries and require a careful and meticulous attention to detail, relative to repair, to achieve the most effective recovery. We found that over a three year period that the zone of injury in the cohort of patients in our region had changed, as well as the unemployment rate. Other parameters were generally similar. We conclude that treatment of flexor tendon injuries should undergo the audit cycle to ensure that best practice is achieved and maintained.