Long term follow-up of functional outcome after flexor tendon injury zone II repaired using unhas suture: A cross-sectional study

One of the most common cases seen in hand injury is the flexor tendon injury. It may affect the activity of the patient's daily living especially in Zone 2 classified by Kleinert and Verdan. Flexor tendon injury management is challenging to give a good functional outcome after the tendon repair. This cross-sectional study took place in Wahidin Sudirohusodo General Hospital, South Sulawesi, from January 2011 to January 2020. A total of 13 subjects and a total of 20 tendons were repaired using Unhas suture. The patients were assessed using Buck-Gramcko II score, Patient Evaluation Measurement Questionnaire, and Hand Grip Strength using a hand dynamometer. A total of 20 tendons injured were followed up from 33 to 112 months after surgery (mean: 80.3 ± 8.2 months). According to Buck-Gramcko Score, four tendons classified as excellent, four tendons classified as very good, eight tendons classified as good, and four tendons classified as fair with a range of 8–16 (mean: 13.10 ± 2.38). None are classified as poor in this study. The 13 subjects were then asked to fill the Patient Evaluation Measurement Questionnaire, and a score of 71.43–91.84% was obtained (mean: 79.59 ± 4.84). The measurement using hand dynamometer had a mean of 72.2% of handgrip strength, with a handgrip deficit of 28%. Unhas suture may provide an excellent functional outcome according to Buck-Gramcko Score and Patient Evaluation Measure Questionnaire with a low complication rate in patients with flexor tendon injury zone II. •Flexor tendon injury is the most common in hand injuries.•Flexor tendon injury may affect the activity of the patient's daily living and may lead to disability.•Zone 2 was recognized as “No Man's Land” because of the poor outcome after the tendon repair in this area.•Unhas suture is a modification of the Tsuge method with 2-strand core suture in a locking loop located in the volar side.•Unhas suture provide an excellent functional outcome according to Buck-Gramcko Score and Patient Evaluation Measurement.