Use of vein graft as a tendon sheath substitute following tendon repair: an innovative technique in tendon surgery.
OBJECTIVE
This is a new technique for managing tendon repair that may improve the results of existing methods.


METHODS
In a prospective randomized clinical trial, 210 patients were divided into two groups of test and control. All patients had flexor tendon injuries, involving zone 2. They were new or old tendon injuries or complications of previous repairs. In the test group (105 patients), a modified Kessler repairing of tendons with 3-0 prolene was used, followed by a core suture of running 6-0 nylon or prolene epitendinous suture. After the tendon repair, a segment of vein through which the tendon had been passed before or a patch of vein, as a tendon sheath substitute, was used to repair the sheath defects. The results in a span of six months of follow-up were compared with those of the control group whereon 105 patients were operated under the conventional technique--the modified Kessler method.


RESULTS
We assessed the results by measuring the range of motion of the MCP joint in the follow-up period and we graded them as excellent, good, fair and poor. In the test group we had 86% excellent, 11% good, 3% fair and 0% poor results, and in the control group, 0% excellent, 12% good, 38% fair and 50% poor results. The differences were significant (p<0.005).


CONCLUSIONS
Our preliminary results appeared encouraging when compared with the outcomes achieved by the conventional tendon repair technique. As this technique reduces the adhesion formation, improves tendon nourishment, and decreases the need of intensive physiotherapy, it may substitute the conventional one and become a standard technique in the future.
Moosavi
S R
SR
Shahid Beheshti University of Medical Sciences, Shohada Medical Center, Department of General, Vascular and Trauma Surgery, Tehran, Iran. seyed29@yahoo.com
Motamedi
A R Kalantar
AR
Tofigh
A M
AM