The effect of hyaluronic acid injection on the outcome of flexor tendon repair in zone II of the hand

Abstract

Background and objective: Flexor tendon injuries of the hand are common, especially in zone II. Various pharmacologic agents have been used to improve the outcome of primary tendon repair. One must select an option that accomplishes an excellent total active movement of the repaired tendon. This study aimed to find out the effect of hyaluronic acid injections in the restoration of normal gliding and power of the repaired tendon. Methods: An interventional study of 47 cases of zone II flexor tendon injury managed from May 2017 to May 2018. The data were assembled in a questionnaire. Standardized photographs for pre-, intra-, and postoperative were taken. Hyaluronic acid injections were used in selected cases. Results: Sharp injury (34 cases, equal to 72%) was found to be the commonest mechanism of flexor tendon injury. Male predominance was noticed (38 cases out of 47) due to their working nature. The hyaluronic acid injection was delivered to selected cases (10 cases, equal to 21%) based on preoperative evaluation. Eighty percent of repairs regained total active movement uneventfully. Few complications happened which responded to conservative management. The P value of total active movement in relation to hyaluronic acid injection was 0.036, which is considered statistically significant. Conclusion: This study shows that intraoperative injection of high molecular weight of hyaluronic acid improves the outcome of flexor tendon repair, presumably by decreasing the chance of adhesion.

Keywords

• flexor tendon injury
• hyaluronic acid
• adhesion