Abstract
Objective: The purpose of the study was to evaluate the results of flexor tendon grafting performed as redo procedure in patients who had previously underwent unsuccessful flexor tendon surgery.
Materials and Methods: Study reports the outcome of deep flexor tendon grafting in 122 fingers of 109 patients in relation to two factors - failed surgery type (tendon suture in 51 fingers vs grafting in 71 fingers) and medical unit type where the failed procedure had been performed (hand surgery in 76 cases vs general trauma in 46 cases).
Results. Redo grafting procedures led to excellent results in 13 fingers of 51 (25,5 %) after failed tendon suture and in 32 fingers of 71 (45,1 %) after failed previous grafting, difference is statistically significant (χ2=4,888; P=0,027). Failures coming from hand surgery departments were reoperated with 48,7 % of excellent results (in 37 fingers of 76) and 14,5 % of fair results (in 11 fingers of 76). Failures after general trauma units surgery were reoperated with 17,4 % of excellent results (in 8 fingers of 46), this difference from hand surgery departments group is statistically significant: χ2=12,054; P=0,001. Fair results were evaluated in 16 fingers of 46 in general trauma units group (34,8 %), this difference from hand surgery departments group was also statistically significant: χ2=6,858; P=0,009.
Conclusion. For a total redo grafting procedures delivered 36,9 % of excellent results (in 45 fingers of 122) and 34,5 % of good results (in 42 fingers of 122), whereas in patients with no surgical history two-stage deep flexor tendon grafting led to excellent results in 264 of a total of 432 fingers (61,1 % of cases), this difference is statistically significant: χ2=22,635; P0,0001. The lowest outcomes of the redo procedures were achieved in patients who had been unsuccessfully operated in general trauma units previously - 17,4% of excellent and 34,8% of good results.