The influence of patient and surgical factors on prognosis in repeated flexor tenorrhaphy

PURPOSE: This study aimed to investigate factors influencing outcome in patients who experienced re-rupture after flexor tenorrhaphy. BACKGROUND: Flexor tendon re-rupture following tenorrhaphy remains a significant complication that can adversely affect functional outcomes and require repeated surgical intervention. This study aimed to investigate factors influencing prognosis in patients who experienced re-rupture after flexor tenorrhaphy. MATERIALS AND METHODS: We retrospectively analyzed patients who underwent flexor tendon tenorrhaphy on little fingers between January 2011 and September 2024 and subsequently experienced re-rupture -followed by a primary repair. We analyzed factors such as re-rupture timing, rupture to surgery interval, patient demographics, medical history, and participation in rehabilitation therapy using a simple linear regression model. Patients with underlying diseases, concurrent fractures, thumb or extensor tendon ruptures, or follow-up periods less than 6 months were excluded. The Adjusted Strickland and Whitaker methods were used for evaluation. RESULTS: A total of 17 patients out of 313 who underwent flexor tendon repair experienced re-rupture and met the inclusion criteria. Age and re-rupture period significantly affected prognosis. Older patients showed poorer final range of motion outcomes. In contrast, the initiation date, frequency, and duration of rehabilitation therapy did not demonstrate statistically significant correlations with prognosis. CONCLUSIONS: Older age and delayed re-rupture were associated with poorer postoperative finger range of motion following repeated flexor tenorrhaphy. Therefore, patients should be advised to avoid excessive hand use until adequate tendon healing is achieved, and thorough postoperative education may be particularly important in elderly patients.