Complications of flexor tendon repair in the hand: MR imaging assessment.
OBJECTIVE
To determine if magnetic resonance (MR) imaging enables differentiation of adhesions from tendon rupture after repair of digital flexor tendon injuries.


METHODS
The reference group comprised eight tendon sutures with a good clinical outcome. Axial and sagittal spin-echo sequences and three-dimensional gradient-echo sequences with curved reconstructions were analyzed in 63 injured fingers. Reoperation was performed in 41 fingers.


RESULTS
MR imaging depicted isolated peritendinous adhesions (n = 31), most often with a continuous, uniform tendon (sensitivity 91%, specificity 100%). There were two types of rupture: frank rupture (n = 140; sensitivity 100%, specificity 100%) or elongated callus (n = 18; sensitivity 100%, specificity 94%). Tendon gap was significantly longer in frank rupture (P = .0011). Thin fibrous continuity existed with elongated callus. Tenolysis was sufficient when the callus was short and mature with predominant new collagen fibers. Axial spin-echo sections were essential, as they showed the maturation of the callus.


CONCLUSIONS
MR imaging may enable distinction among several complications that occur after repair of an injured digital flexor tendon.
Department of Skeletal Radiology, Hôpital Bichat 46, Paris, France.
J L
JL
Drapé
O
O
Silbermann-Hoffman
P
P
Houvet
T
T
Dubert
A
A
Thivet
Z
Z
Benmelha
B
B
Frot
J Y
JY
Alnot
R
R
Benacerraf
D000293:Adolescent; D000328:Adult; D005260:Female; D005383:Finger Injuries / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D005385:Fingers / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis*; D012421:Rupture; D012680:Sensitivity and Specificity; D013537:Sutures; D013708:Tendon Injuries / Q000473:pathology / Q000601:surgery*; D013710:Tendons / Q000473:pathology; D000267:Tissue Adhesions / Q000175:diagnosis