Complications after flexor tendon surgery: A retrospective cohort study of 336 patients

BACKGROUND: The management of flexor tendon injuries in the hand is a well-known challenge worldwide, and postoperative complications have been reported with a pronounced incidence. However, little is known about possible associations with adverse events following surgery.

PURPOSE: The aim of this study was to report outcomes and incidence of postoperative complications in patients undergoing surgery after traumatic flexor tendon injuries in the hand.

METHODS: We retrospectively reviewed medical records of 336 patients who had been surgically treated for flexor tendon injuries of the hand in two hospitals in the period of 2010-2020. We divided patients in groups and compared those with major complications (n = 56) to those without (n = 280). Major postoperative complications were defined as rerupture, adhesion leading to surgery and infection leading to revision and/or admission.

RESULTS: In total, 17 % experienced a major complication following surgery. We found that 7.7 % of patients experienced rerupture of the sutured tendon, 6.5 % of patients experienced adhesion leading to tenolysis and 2.4 % experienced infection leading to revision and/or admission. Traumas in zone II of the hand and lesions in both flexor digitorum superficialis and profundus were both separately associated with a greater risk of major complications (OR 2.132 and OR 2.317, respectively).

CONCLUSION: The incidence of patients experiencing major complications following flexor tendon surgery is 17 %, and patients with traumas in zone II of the hand and multiple tendon lesions have a higher risk of experiencing a major postoperative complication.