Contributing factors to hand flexor tendon rerupture

Purpose: This retrospective study aimed to identify factors influencing hand flexor tendon rerupture and to develop preventive strategies for patients who have undergone hand flexor tendon repair.Methods: In total, 287 patients who underwent hand flexor tendon repair between January 2011 and June 2022 were included. Patients with thumb injuries, amputations, bone injuries, extensor tendon injuries, and those with less than 3 months of follow-up were excluded. Patients were divided into rerupture and non-rerupture groups. Events leading to ruptures were also investigated. The two groups were compared according to sex, age, occupation, smoking status, history of diabetes mellitus, injury characteristics, core suture method, and timing of the rehabilitation course.Results: Of the 287 patients, 19 experienced rerupture (6.6%). The mean time to rerupture was 25.3 days. Reruptures occurred due to unknown causes in nine cases (47.4%), noncompliance with medical recommendations in seven cases (36.8%), and trauma in three cases (15.8%). Among the investigated factors, little finger injury and concurrent flexor digitorum superficialis (FDS) and flexor digitorum profundus (FDP) ruptures were significantly associated with rerupture. Little difference was noted in the core suture methods and timing of the rehabilitation course between the two groups.Conclusion: To minimize the risk of rerupture, patients should strictly adhere to medical recommendations and avoid any activities that could cause trauma for at least 1 month after surgery, which is the critical period for tendon remodeling. Patients with little finger injuries as well as concurrent FDS and FDP ruptures require special attention and careful monitoring.