Abstract
Early repair of flexor tendon injuries is ideal, but delays are common. We studied the outcomes of flexor tendon repairs delayed from 5 days to 6 months and carried out under wide-awake local anaesthesia with no tourniquet (WALANT). Twenty-four patients (29 fingers) who underwent primary flexor tendon repair on zone II using a four- to six-strand core suture technique, followed by controlled early active motion therapy. Clinical assessments, including total active motion (TAM) and Disabilities of the Arm, Shoulder and Hand, were made 6, 8 and 12 weeks after operation. All outcomes improved significantly over time. At the final assessment, 93% of fingers showed excellent TAM outcomes. Extension deficit was between 5° and 20° in eight of 26 fingers. The results of this study suggest that delayed primary flexor tendon repair under WALANT can achieve excellent functional outcomes, although longer follow-up is needed for extension deficit recovery.
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