Efficacy Comparison of Various Repair Techniques for Flexor Tendon Injuries: A Systematic Review and Meta-Analysis
Background: Flexor tendon injuries are potentially disabling, as flexor tendons are essential to hand function, playing a vital role in all types of grip, including power and fine pinch grips. However, there has been no consensus regarding the most effective repair technique for this pathology. Meth...
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Universitas Airlangga
2021-04-01
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| Series: | Journal Orthopaedi and Traumatology Surabaya |
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| Online Access: | https://e-journal.unair.ac.id/JOINTS/article/view/24035 |
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| author | Anak Agung Gde Duta Maha Putra Made Bramantya Karna Anak Agung Gde Yuda Asmara Putu Feryawan Meregawa |
| author_facet | Anak Agung Gde Duta Maha Putra Made Bramantya Karna Anak Agung Gde Yuda Asmara Putu Feryawan Meregawa |
| author_sort | Anak Agung Gde Duta Maha Putra |
| collection | DOAJ |
| description | Background: Flexor tendon injuries are potentially disabling, as flexor tendons are essential to hand function, playing a vital role in all types of grip, including power and fine pinch grips. However, there has been no consensus regarding the most effective repair technique for this pathology.
Methods: A systematic search was conducted based on PRISMA guidelines to identify relevant studies through PubMed, Google Scholar, and Cochrane. A total of 9 studies (266 tendons from 108 patients) were included.
Results: In a comparison between the Modified Kessler and 4-stranded Cruciate techniques, the Four-stranded Cruciate Suture produces a higher 2 mm gap strength (I2 = 93%, p < 0.00001), higher ultimate strength (I2 = 99%, p = 0.02), and better Functional Outcome as measured using the Strickland Criteria (I2 = 0%, p < 0.0001). In a comparison between the 2-Stranded and the 4-Stranded Kessler technique, the 4-Stranded Kessler technique produces a higher 2 mm gap strength (I2= 98%, p =0.02) and higher ultimate strength (I2= 60%, p <0.00001).
Conclusion: The current systematic review and meta-analysis suggests that the 4-stranded cruciate repair technique has better strength and functional outcomes than the modified Kessler, especially in zone II and III injuries. The 4-stranded Kessler is also proven to have better strength compared to the 2-stranded Kessler. |
| format | Article |
| id | doaj-art-c69c70f3036044da810b61ce4b372a8a |
| institution | Kabale University |
| issn | 2722-712X 2460-8742 |
| language | English |
| publishDate | 2021-04-01 |
| publisher | Universitas Airlangga |
| record_format | Article |
| series | Journal Orthopaedi and Traumatology Surabaya |
| spelling | doaj-art-c69c70f3036044da810b61ce4b372a8a2025-02-12T07:28:37ZengUniversitas AirlanggaJournal Orthopaedi and Traumatology Surabaya2722-712X2460-87422021-04-01101112110.20473/joints.v10i1.2021.11-2119721Efficacy Comparison of Various Repair Techniques for Flexor Tendon Injuries: A Systematic Review and Meta-AnalysisAnak Agung Gde Duta Maha Putra0Made Bramantya Karna1https://orcid.org/0000-0001-5483-5132Anak Agung Gde Yuda Asmara2https://orcid.org/0000-0002-3280-7613Putu Feryawan Meregawa3https://orcid.org/0000-0003-0086-9673Department of Orthopedics and Traumatology Sanglah Hospital/Universitas Udayana, Denpasar, IndonesiaDepartment of Orthopedics and Traumatology Sanglah Hospital/Universitas Udayana, Denpasar, IndonesiaDepartment of Orthopedics and Traumatology Sanglah Hospital/Universitas Udayana, Denpasar, IndonesiDepartment of Orthopedics and Traumatology Sanglah Hospital/Universitas Udayana, Denpasar, IndonesiaBackground: Flexor tendon injuries are potentially disabling, as flexor tendons are essential to hand function, playing a vital role in all types of grip, including power and fine pinch grips. However, there has been no consensus regarding the most effective repair technique for this pathology. Methods: A systematic search was conducted based on PRISMA guidelines to identify relevant studies through PubMed, Google Scholar, and Cochrane. A total of 9 studies (266 tendons from 108 patients) were included. Results: In a comparison between the Modified Kessler and 4-stranded Cruciate techniques, the Four-stranded Cruciate Suture produces a higher 2 mm gap strength (I2 = 93%, p < 0.00001), higher ultimate strength (I2 = 99%, p = 0.02), and better Functional Outcome as measured using the Strickland Criteria (I2 = 0%, p < 0.0001). In a comparison between the 2-Stranded and the 4-Stranded Kessler technique, the 4-Stranded Kessler technique produces a higher 2 mm gap strength (I2= 98%, p =0.02) and higher ultimate strength (I2= 60%, p <0.00001). Conclusion: The current systematic review and meta-analysis suggests that the 4-stranded cruciate repair technique has better strength and functional outcomes than the modified Kessler, especially in zone II and III injuries. The 4-stranded Kessler is also proven to have better strength compared to the 2-stranded Kessler.https://e-journal.unair.ac.id/JOINTS/article/view/24035biomechanicscruciateflexor tendonkesslertendon repair |
| spellingShingle | Anak Agung Gde Duta Maha Putra Made Bramantya Karna Anak Agung Gde Yuda Asmara Putu Feryawan Meregawa Efficacy Comparison of Various Repair Techniques for Flexor Tendon Injuries: A Systematic Review and Meta-Analysis Journal Orthopaedi and Traumatology Surabaya biomechanics cruciate flexor tendon kessler tendon repair |
| title | Efficacy Comparison of Various Repair Techniques for Flexor Tendon Injuries: A Systematic Review and Meta-Analysis |
| title_full | Efficacy Comparison of Various Repair Techniques for Flexor Tendon Injuries: A Systematic Review and Meta-Analysis |
| title_fullStr | Efficacy Comparison of Various Repair Techniques for Flexor Tendon Injuries: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Efficacy Comparison of Various Repair Techniques for Flexor Tendon Injuries: A Systematic Review and Meta-Analysis |
| title_short | Efficacy Comparison of Various Repair Techniques for Flexor Tendon Injuries: A Systematic Review and Meta-Analysis |
| title_sort | efficacy comparison of various repair techniques for flexor tendon injuries a systematic review and meta analysis |
| topic | biomechanics cruciate flexor tendon kessler tendon repair |
| url | https://e-journal.unair.ac.id/JOINTS/article/view/24035 |
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