The Clinical Efficacy of Fat Injection on the Repair of Hand Flexor Tendon: A Randomized Clinical Trial.

IF 0.9 Q3 SURGERY World Journal of Plastic Surgery Pub Date : 2023-01-01 DOI:10.52547/wjps.12.2.41
Siamak Farokh Forghani, Hojjat Haghighimanesh, Tayyeb Ghadimi, Hossein Akbari, Hamidreza Farahmand, Soheila Naderi Gharahgheshlagh, Seyed Ehsan Mousavi-Lajimi
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Abstract

Background: In recent years, special attention has been paid to minimally invasive and conservative methods in addition to conventional surgical methods to repair tendon damage. In this regard, the effect of fat injection and graft has been of great interest due to its potential in accelerating tissue repair. We aimed to assess the clinical efficacy of fat injection along with conventional approach in patients with flexor tendon injury.

Methods: In this randomized clinical trial, 64 patients were randomly scheduled for tendon repair using the usual modified Kessler four-strand method alone or tendon repair using four-strand method and fat injection on the proximal and distal sides of the repair site in the Hazrat Fatemeh Hospital, Tehran Province, Iran in 2022 (IRCT20221206056723N1). Patients were followed-up for eight weeks regarding the function status of the repaired tendon (using Strickland grading test), range of motion (by physical examination) and flexion and extension gaps (by imaging).

Results: In the eighth weeks after the treatment, the average Strickland score was significantly higher in the group receiving fat injection (P: 0.009 ). In the two pointed times, the mean range of motion was significantly higher and the mean flexion and extension gaps were significantly lower in those who received fat injection. None of the procedural side effects were observed in the fifth and eighth weeks after the treatment.

Conclusion: Fat injection along with usual surgical treatment for tendon repair accelerates and improves tendon function and range of motion.

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脂肪注射对修复手部屈肌腱的临床疗效:随机临床试验
背景:近年来,除传统手术方法外,微创和保守方法也受到特别关注,以修复肌腱损伤。在这方面,脂肪注射和移植因其在加速组织修复方面的潜力而备受关注。我们的目的是评估脂肪注射和传统方法在屈肌腱损伤患者中的临床疗效:在这项随机临床试验中,伊朗德黑兰省 Hazrat Fatemeh 医院(IRCT20221206056723N1)于 2022 年随机安排了 64 名患者进行肌腱修复,修复方法包括单独使用通常的改良 Kessler 四股法,或使用四股法并在修复部位的近端和远端注射脂肪(IRCT20221206056723N1)。对患者进行了为期八周的随访,以了解修复肌腱的功能状况(使用斯特里克兰分级测试)、活动范围(通过体格检查)以及屈伸间隙(通过影像学检查):治疗后第八周,接受脂肪注射组的平均斯特里克兰德评分明显更高(P:0.009)。接受脂肪注射组的平均活动范围明显更大,平均屈伸间隙明显更小。治疗后第五周和第八周均未观察到手术副作用:结论:在肌腱修复的常规手术治疗的同时进行脂肪注射,可加快和改善肌腱的功能和活动范围。
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