Tendon Repair Within 6 Hours After Injury in Zone 2B is Associated With Higher Anxiety But Similar Functional Outcomes

Aim: Optimal timing for flexor tendon repair in zone 2B remains controversial, particularly regarding its psychological impact on patients. This prospective study aimed to evaluate whether the timing of tendon repair influenced patient anxiety levels and functional outcomes.Materials and Methods: Seventy-seven patients aged 18 years or older with flexor tendon injuries in zone 2B were enrolled prospectively and divided into three groups based on surgical timing from injury to surgery: Group 1 (0–6 hours, n=28), Group 2 (6–24 hours, n=30), and Group 3 (24–72 hours, n=19). Anxiety was assessed using the State-Trait Anxiety Inventory (STAI) and a visual analog scale (VAS-A) at four distinct periods: at admission, immediately before surgery, 7–10 days postoperatively, and one year postoperatively. The Quality of Recovery-40 (QoR-40) and Strickland criteria were used to assess postoperative recovery and functional outcomes, respectively.Results: Preoperative anxiety levels (STAI-1) were significantly higher in Group 1 compared to other repair groups (p < 0.05). Postoperative anxiety and QoR-40 scores showed no significant differences between groups at any time point (p>0.05). Functional outcomes assessed by Strickland criteria were excellent in 74.0%, good in 24.6%, and moderate in 1.2% of patients, without differences across groups (p>0.05). Within-group analyses showed a significant postoperative reduction in anxiety compared to preoperative scores in all groups (p<0.05).Conclusions: Tendon repair performed within six hours of injury in flexor zone 2B is associated with significantly higher preoperative anxiety. However, surgical timing does not affect postoperative anxiety or functional outcomes. Preoperative anxiety management strategies should be considered in early tendon repair to optimize patient experience.