The purpose of this study was to investigate the epidemiology of flexor tendon injuries and operative complications post-repair on a national scale. Using Hospital Episode Statistics data we identified a total of 91,239 patients in England who underwent a flexor tendon repair in the 20-year period between 1 April 1998 and 31 March 2018. Individuals were more likely to be male (74.6%) and of lower socioeconomic status. Median age was 31 years and patients had few medical comorbidities. After primary repair, 3.1% of patients required a revision repair within 90 days and 2.8% tenolysis within two years. Complications other than rupture, adhesions and wound site infection were rare. This study has shown that flexor tendon repair is primarily a procedure of working-age men, with rupture and adhesions the most common complication. The complication rate is less than previously reported in the literature.
AlserOCraigRSLaneJCE, et al.
Serious complications and risk of re-operation after Dupuytren’s disease surgery: a population-based cohort study of 121,488 patients in England. Sci Rep. 2020,
10: 1–10.
2.
AnakweREAitkenSACowieJGMiddletonSDCourt-BrownCM.The epidemiology of fractures of the hand and the influence of social deprivation. J Hand Surg Eur. 2011,
36: 62–5.
3.
AngermannPLohmannM.Injuries to the hand and wrist. A study of 50,272 injuries. J Hand Surg Br. 1993,
18: 642–4.
4.
BebbingtonEFurnissD.Linear regression analysis of Hospital Episode Statistics predicts a large increase in demand for elective hand surgery in England. J Plast Reconstr Aesthetic Surg. 2015,
68: 243–51.
5.
BortolussiGMcNultyDWaheedHMawhinneyJAFreemantleNPaganoD.Identifying cardiac surgery operations in hospital episode statistics administrative database, with an OPCS-based classification of procedures, validated against clinical data. BMJ Open. 2019,
9.
6.
ClarkDPScottRNAndersonIW.Hand problems in an accident and emergency department. J Hand Surg Br. 1985,
10: 297–9.
7.
CominettiNCostaREylesAMoevTVentuaG. Changing Jobs? The Economy Inquiry 2030, 2022.
DyCJHernandez-SoriaAMaYRobertsTRDaluiskiA.Complications after flexor tendon repair: a systematic review and meta-analysis. J Hand Surg Am. 2012,
37: 543–52.
10.
von ElmEAltmanDGEggerM, et al.
The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Prev Med (Baltim). 2007,
45: 247–51.
11.
GreenRUzohoCArrowsmithJBainbridgeCJohnsonNA.Tool and machinery-related hand injuries: a review of national Hospital Episodes Statistics and data from a tertiary hand unit. J Hand Surg Eur. 2021,
46: 188–92.
12.
GreggPWadsworthJ. The UK Labour Market and the 2008–2009 Recession. Centre for Economic Performance. 2010.
13.
HardwickeJTTanJJFosterMATitleyOG.A systematic review of 2-strand versus multistrand core suture techniques and functional outcome after digital flexor tendon repair. J Hand Surg Am. 2014,
39(4): 686–95.e2.
14.
IshakARajangamAKhajuriaA.The evidence-base for the management of flexor tendon injuries of the hand: review. Ann Med Surg. 2019,
48: 1–6.
15.
LaneJCECraigRSReesJL, et al.
Serious postoperative complications and reoperation after carpal tunnel decompression surgery in England: a nationwide cohort analysis. Lancet Rheumatol. 2020,
9913: 1–9.
16.
ManleyOWGWormaldJCRFurnissD.The changing shape of hand trauma: an analysis of Hospital Episode Statistics in England. J Hand Surg Eur. 2019,
44: 532–6.
17.
MetcalfeDJudgeAPerryDCGabbeBZoggCKCostaML.Total hip arthroplasty versus hemiarthroplasty for independently mobile older adults with intracapsular hip fractures. BMC Musculoskelet Disord. 2019,
20: 1–11.
18.
Ministry of Housing Communities & Local Government. The English Indices of Deprivation. 2019.
19.
MujadzićMPirela-CruzMKanlićE.Updates in flexor tendon repair at zone II. Bosn J Basic Med Sci. 2005, (3):16–25.
QuanHLiBCourisCM, et al.
Updating and validating the Charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries. Am J Epidemiol. 2011,
173: 676–82.
25.
SvingenJWiigMTuressonCFarneboSArnerM.Risk factors for reoperation after flexor tendon repair: a registry study. J Hand Surg Eur. 2022,
47: 1071–6.
26.
TangJBLalondeDHarhausLSadekAFMoriyaKPanZJ.Flexor tendon repair: recent changes and current methods. J Hand Surg Eur. 2022,
47(1): 31–9.
27.
ThornJCTurnerEHounsomeL, et al.
Validation of the Hospital Episode Statistics Outpatient Dataset in England. Pharmacoeconomics. 2016,
34: 161–8.
28.
WongJKFPeckF.Improving results of flexor tendon repair and rehabilitation. Plast Reconstr Surg. 2014,
134: 913e–25e.
29.
World Health Organization. International Classification of Disease version 10. 2010. https://icd.who.int/browse10/2010/en (accessed 14 February 2022).
30.
XuHHuangXGuoZZhouHJinHHuangX.Outcome of surgical repair and rehabilitation of flexor tendon injuries in zone II of the hand: systematic review and meta-analysis. J Hand Surg Am. 2023,
48(4): 407.e1–e11.
