Clinician- and patient-reported outcomes after flexor tendon repair: A 1-year prospective study.

Abstract

Background: Evaluation following flexor tendon repairs has largely focused on clinician-reported measures of active range of motion and grip strength.

Purpose: To track recovery after digit 1-5, zone I-III over 1year using regular clinician- and patient-reported outcomes.

Study design: Prospective cohort study.

Methods: Patients aged ≥18years undergoing early active mobilization were included. Clinician-reported outcomes were active range of motion, grip strength, proximal interphalangeal flexion contractures, hours in therapy, and number of orthoses. Patient-rated outcomes included Patient-rated wrist and hand evaluation, the Measurement of Activity Performance of the hand, difficulties with home exercises, and satisfaction with hand function.

Results: The 45 participants with 65 repaired tendons showed a steady increase in active range of motion and grip strength over 12months. At the final follow-up, 73% of fingers achieved excellent/good outcomes per Strickland and Glogovac criteria and there were four proximal interphalangeal joint contractures ≥20 degrees, all present at 1month. The participants had on average 10 hand therapy visits over 5months and 2.4 orthoses. Patient-rated wrist and hand evaluation and Measurement of Activity Performance of the hand scores indicated low pain and good overall function, but activities of daily living, such as opening jars and buttoning, remained difficult up to 12months in some participants. Patients reporting difficulties with the home exercise program increased progressively from 1-3months. At 12months, only one patient was not satisfied with hand function.

Conclusions: Despite good active range of motion at 12months, early proximal interphalangeal joint contractures persisted, and some activities remained challenging.