title: Effect of Heparin on Post-Operative Adhesion in Flexor Tendon Surgery of the Hand.
abstract: Flexor tendon laceration is a common hand injury. Timely and correct diagnosis of this defect is an important factor for restoring hand function. Post-operative adhesion is a frequent problem after tendon repair and its prevention is difficult in some types of tendon lacerations. There have been some controversial studies on the positive effect of some materials and substances on prevention of these adhesions. This study aims to evaluate effects of the Heparin in postoperative tendon adhesions. In this clinical trial, 100 patients with laceration of flexor tendons in zone II of the hand were enrolled. The patients were randomly divided into two groups. In the first group, 0.5 cc Heparin (5000 IU/cc) was injected into each tendon ends before tendon repair. In the control group, repair was carried out without any heparin injection. After 3 months the total active range of motion (TAROM), mean extension gap (MEG) and mean flexion gap (MFG) were measured and compared between these two groups. The TAROM and MEGs were not significantly different between two groups; but MFGs were significantly better in Heparin treated group (P < 0.02). However rupture rate was significantly higher in heparin treated group (P = 0.003). Heparin may improve the tendons function and reduce the postoperative adhesions in zone II of the hand; however there is a significant risk of tendon rupture.
authors.affiliation: Plastic and Reconstructive Surgery, Hazrat Fateme Hospital, Iran University of Medical Science, Tehran, Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Akbari
authors.affiliation: Plastic and Reconstructive Surgery, Medical Branch of Islamic Azad University, Tehran, Iran.
authors.forename: Amir Asadollah Khajeh
authors.initials: AA
authors.lastname: Rahimi
authors.affiliation: Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Yaser
authors.initials: Y
authors.lastname: Ghavami
authors.affiliation: Burn Research Center, Iran University of medical Science, Tehran, Iran.
authors.forename: Seyed Jaber
authors.initials: SJ
authors.lastname: Mousavi
authors.affiliation: Hazrat Fateme Hospital and Burn Research Center, Iran University of Medical Science, Tehran, Iran ; Shahid Motahari Burn Hospital, Iran University of medical sciences (IUMS), Vali-asr Ave., Yasami St., Tehran, 1996714353 Iran.
authors.forename: Mohammad Javad
authors.initials: MJ
authors.lastname: Fatemi
keywords: Flexor tendon; Heparin; Tendon adhesion; Tendon rupture