Comparative analysis of hand function after surgical repair of finger flexor tendons

BACKGROUND: Surgical treatment of flexor tendon injuries is associated with a high rate of poor outcomes and disability. Improving treatment results may be achieved by searching for new suture materials. Numerous reports in the scientific data describe the potential use of nickel-titanium–based materials in surgery; however, no references to the use of nickel-titanium wire in tendon surgical reconstruction have been reported. AIM: To conduct a comparative study of long-term outcomes in patients with flexor tendon injuries of the triphalangeal fingers in the osteofibrous canal zone, using a superelastic nickel-titanium wire and a polypropylene thread. METHODS: An interventional, single-center, prospective, controlled, non-randomized clinical study included 110 patients with injuries of the flexor digitorum profundus tendons in the osteofibrous canal zone. Patients were divided into two groups: the main group (n = 65), where a superelastic nickel-titanium wire was used, and the control group (n = 45), where polypropylene was applied. Surgical repair was performed using the M-Tang technique with a six-strand suture in both groups. Follow-up lasted 12 months, with control points at days 7–10, weeks 3 and 6, and months 3, 6, and 12. The primary endpoint was functional recovery of the finger assessed with the FingerSurg scale by measuring active joint motion and comparing it with the uninjured finger. Additionally, grip strength, pinch strength, and DASH questionnaire scores were recorded. RESULTS: Use of the superelastic nickel-titanium wire in tendon suturing of the flexor digitorum profundus demonstrated a higher rate of excellent results (78.5%) and a significantly lower rate of poor outcomes (1.5%) compared with the control group (p = 0.042). Grip and pinch strength recovery was also superior, especially in patients with incised wounds and early surgical intervention. No differences in quality of life as measured by the DASH score were found between the groups at 12 months. CONCLUSION: The results of this clinical study of hand function after surgical repair of flexor tendons at the level of the osteofibrous canal confirmed the advantages of the proposed tendon suture technique by reducing complication rates and improving postoperative outcomes.