Long-term results of early primary repair of flexor pollicis longus tendon injuries

We evaluated the long-term results of early primary repair of flexor pollicis longus (FPL) tendon injuries with the modified Kessler method and circumferential sutures. Thirty patients (10 females, 20 males; mean age 26 years; range 4 to 52 years) were treated primarily with end-to-end anastomosis for FPL tendon injuries at the level of zone I to IV. Injuries were in the left thumb in 16 patients and in the right thumb in 14 patients. They were localized in zone I in one patient, zone II in 15 patients, zone III in nine patients, and zone IV in five patents. Twenty-five patients were treated within the first few hours after injury, while five patients were treated within a period ranging from 1 to 34 days. Associated digital artery and nerve injuries in 23 patients were treated during the same session. A rehabilitation program was implemented according to the modified Duran method. Functional evaluations were made according to the Buck-Gramcko system. The mean follow-up was 34 months (range 5 to 71 months). Functional results were excellent in 17 patients (56.6%), good in five patients (16.6%), fair in five patients (16.6%), and poor in three patients (9.9%). Excellent and good results accounted for 73.3% and 88.8% in zone II and zone III injuries, respectively. No significant differences existed between functional results obtained from patients with and without associated neurovascular injuries. Early primary end-to-end repair followed by an appropriate rehabilitation program yields very good functional results in patients with FPL tendon injuries, whether or not they are associated with neurovascular injuries.