Risk Factors Associated with Complications in Flexor Tendon Repairs in Zones 1 and 2

Abstract Introduction Flexor tendon injuries in the hand are frequently encountered in hand surgery practice and can lead to significant functional loss if not treated properly.. This study aims to investigate the risk factors associated with complications following primary repair of flexor tendon injuries in zones 1 and 2. Methods The research was conducted retrospectively, collecting data on variables such as age, gender, educational status, income level, smoking habits, psychiatric conditions, injured tendons and fingers, injury mechanisms, surgical techniques, suture types, and rehabilitation status. Results Smoking was found to significantly increase the risk of complications; while 67.6% of non-smokers did not experience tendon rupture, 100% of smokers did (p = 0.046). Moreover, smokers were found to have lower TAM (Total Active Motion) scores (p = 0.003). A significant association was also found between educational status and complications, with high school graduates being more likely to experience complications (p = 0.001). Rehabilitation status further impacted the complication rate, as patients who underwent rehabilitation had higher complication rates (p = 0.048). The median time to return to work for patients with complications was significantly longer compared to those without complications (p < 0.001). Injured fingers, subzones of injury, suture types, suture techniques, and certain patient-related factors were not found to have significant effects on complications. Conclusion These findings emphasize the substantial impact of smoking and rehabilitation practices on the risk of complications, suggesting that future studies should further evaluate these areas in more detail. Keywords: Flexor tendon injury, complications, risk factors, smoking, rehabilitation