Patient outcomes and costs after isolated flexor tendon repairs of the hand

Biometric analysis hand parameters in young adults for prosthetic hand and ergonomic product applications

This study aimed to evaluate the superficial anatomy, kinesiology, and functions of the hand to reveal its morphometry and apply the findings in various fields such as prosthetic hand and protective hand support product design. We examined 51 young adults (32 females, 19 males) aged between 18-30. Hand photographs were taken, and measurements were conducted using ImageJ software. Pearson correlation analysis was performed to determine the relationship between personal information and the parameters. The results of the measurements showed the average lengths of finger segments: thumb (49.5±5.5 mm), index finger (63.9±4.1 mm), middle finger (70.7±5.2 mm), ring finger (65.5±4.8 mm), and little finger (53.3±4.3 mm). Both females and males, the left index finger was measured longer than the right index finger. The right ring finger was found to be longer than the left in both sexes. Additionally, length differences between fingers in extended and maximally adducted positions were determined: thumb-index finger (56.1±6.2 mm), index-middle finger (10.7±4.1 mm), middle-ring finger (10.8±1.4 mm), and ring-little finger (25.6±2.7 mm). Other findings included the average radial natural angle (56.4°±10.5°), ulnar natural angle (23.4°±7.1°), radial deviation angle (65.2°±8.2°), ulnar deviation angle (51.2°±9.6°), and grasping/gripping angle (49.1°±5.8°). The average angles between fingers in maximum abduction positions were also measured: thumb-index finger (53.4°±6.5°), index-middle finger (17.2°±2.6°), middle-ring finger (14.3°±2.3°), and ring-little finger (32.1°±7.0°). The study examined the variability in the positioning of proximal interphalangeal joints during maximum metacarpophalangeal and proximal interphalangeal flexion, coinciding with maximum distal interphalangeal extension movements. The focal points of our observations were the asymmetrical and symmetrical arches formed by these joints. This study provides valuable hand parameters in young adults, which can be utilized in various applications such as prosthetic design, ergonomic product development, and hand-related research. The results highlight the significance of considering individual factors when assessing hand morphology and function.

Mental and behavioural disorders increase the risk of tendon rupture after flexor tendon repair in zone I and II

Introduction

The effect of mental and behavioural disorders (MBD) on the risk of tendon ruptures after flexor tendon repair is not well understood. This study aimed to analyse the association between MBD and tendon rupture after flexor tendon repair in zones I and II.

Methods

Data from the Swedish National Registry for Hand Surgery (HAKIR) on patients with a complete flexor tendon repair at our department between 2012 and 2019 were followed for a minimum of 2 years to assess the rate of rupture. Independent variables were collected from HAKIR and clinical records: prevalence MBD based on ICD-10 codes F0-F99, age, sex, injured tendon, number of injured fingers, day to surgery, core suture, digital nerve injury, smoking, injury mechanism, and rehabilitation method. Multiple logistic regression was used to assess the association between variables.

Results

A cohort of 593 patients with 49 ruptures (8.2%) was identified. Potential causes of rupture were non-adherence behaviour in 16 (33%), accidents in seven (14%), infections in six (12%), and no clear cause in 20 (41%) patients. Patients with MBD had an association to rupture (OR 3.6), 17.7% ruptures compared to 7.2% in patients with no diagnosed disorders. Patients >50 years of age had a higher risk compared to patients <25 years (OR 4.3), 15% compared to 3.9%' respectively. Men had a higher risk compared to women (OR 2.9), 10% compared to 4.3%' respectively.

Conclusion

We identified an association between the prevalence of mental and behavioural disorders and rupture after flexor tendon repair.