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Results After Surgery for Tendon Repair in Children

This is the first report published on the results of extensor tendon repair in children under the age of 15 years. Children included in the study ranged in age from 12 months to 15 years. Most of the cuts occurred from a sharp object such as glass, knife, or scissors.

Surgery to repair the damage was done within 24 hours in all cases. The authors carefully described the zones and locations of the tendon lacerations. The authors specifically looked at factors that might affect the outcomes.

Everyone was followed for at least one year after surgery. Some patients were followed for up to five years. Various types of repair procedures were used.

Results were measured by range of motion, function, and the presence of extensor tendon lag. Lag refers to an incomplete extension of the distal interphalangeal (DIP) joint. When the patient makes a fist and then extends the affected finger, the tip of the finger doesn't straighten all the way.

Grip and pinch strength are often used as measures of results for hand injuries. They were not included in this study because of the young age of some patients.

Age, location of injury, and extent of injury were the most important factors influencing the results. Younger children (less than five years old) were more likely to have an extension lag. This may be because smaller fingers are harder to keep immobilized after surgery.

The authors report that children with complete lacerations had worse results than those with a partial tendon cuts. Extensor tendon lag was more likely when there was a complete tendon laceration.

Overall, the results were good to excellent. Extensor lag was the biggest mid- to long-term problem. Extensor tendon injuries don't occur very often in children.

Studies comparing treatment are difficult because there are so many differences from patient to patient. Many times the injury involves skin loss or bone fractures. Isolated tendon lacerations occur much less often.

References: Frank Fitoussi, MD, et al. Extensor Tendon Injuries in Children. In Journal of Pediatric Orthopaedics. December 2007. Vol. 27. No. 8. Pp. 863-866.

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