Negative Predictors of Outcomes of Flexor Tendon Repairs
| Autor: | C M Hurley, Frank Reilly, Simon Callaghan, M N Baig |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
030204 cardiovascular system & hematology Affect (psychology) Trauma Outcome (game theory) smoking 03 medical and health sciences 0302 clinical medicine flexor tendon repair timing medicine Prospective cohort study Flexor tendon business.industry General Engineering Biomechanics Plastic Surgery Hand surgery negative predictor Triage Tendon Orthopedics medicine.anatomical_structure age Physical therapy business 030217 neurology & neurosurgery |
| Zdroj: | Cureus |
| ISSN: | 2168-8184 |
| DOI: | 10.7759/cureus.4303 |
| Popis: | The current trend in hand surgery has streamlined the treatment of acute hand trauma to the modern-day surgery unit. As the volume of hand trauma caseloads continues to increase, it is becoming increasingly difficult to schedule patients for theater on the day of injury. It, therefore, becomes paramount to adequately triage patients in accordance with best clinical evidence and predictors of poor clinical outcomes. Animal models suggest that the earlier flexor tendons are repaired, the better the patient functional outcome. The largest study to date examining the timing of injury to functional post-operative outcome also recognizes that the faster these injuries are repaired, the better the patient outcome. Age-related changes to tendon biomechanics and structure are well-documented. However, no conclusive evidence exists specific to the degenerative changes and mechanical properties of flexor tendons in humans. The animal model strongly suggests that increasing age is associated with local architectural and biological changes that directly affect the tendon repair functional outcome. Although retrospective analyses to date suggest that smoking is a negative outcome predictor for functional tendon outcome, no prospective large-scale studies exist. A large, single-center prospective study specifically examining the positive and negative outcome predictors of flexor tendon repairs and functional post-operative outcome is warranted. The negative predictive model of patient care may enable us to further council patients preoperatively and stratify patients according to clinical need. |
| Databáze: | OpenAIRE |
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