Effect of Tendon Wrapping with Amniotic Membrane on Zone 6 Extensor Tendon Repair Outcomes.

Abstract

Background: Extensor tendon repair is prone to adhesion that affects the outcomes of tendon repair surgery and tendon function regain. Prevention of these complications should be considered in tendon rupture treatment. We aimed to evaluate the effect of tendon wrapping with amniotic membrane on the outcomes of extensor tendon repair in zone 6.

Methods: This randomized controlled clinical trial was conducted on 30 patients with an extensor tendon injury in zone 6 following penetrating trauma to extensor digitorum communis of the third and fourth digits referred to 15 Khordad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran . Patients were randomly assigned into two matched groups based on age and gender. Both groups underwent tendon repair using the modified Kessler method. In the intervention group (n=15), the repair site was wrapped with an amniotic membrane, while the control group underwent the traditional procedure without wrapping. Both groups underwent a similar rehabilitation process. Patients were followed up for 6 months. The QuickDash score, range of motion (ROM), complications, and recovery duration were recorded for patients in both groups.

Results: The patients in the intervention group had a lower QuickDash score (P<0.001), ROM (P<0.001), and shorter recovery duration (P<0.001) compared to the control group. The only complication was a wound infection that was seen in one patient in the control group. There was no evidence of tendon re-rupture and amniotic membrane hypersensitivity among patients.

Conclusion: Amniotic, wrapping is an effective method in extensor tendon repair and is associated with better outcomes and faster recovery, suggesting less peritendinous fibrosis.