TY - JOUR ID - TI - Wide-Awake Flexor Tendon Repair Under Tumescent Injection AU - Hanan Zuhair Abid حنان زهير عبد AU - Sabah Hasan Naji صباح حسن ناجي PY - 2019 VL - 1 IS - 1 SP - 39 EP - 51 JO - Iraqi National journal of Medicine المجلة العراقية الوطنية للطب SN - 26647516 26647524 AB - Background. Flexor tendon injuries are frequent, due to variable handactivities, and the repair is challenging to hand surgeons, especially in zone II,because of the coexistence of two tendons within a tight fibro-osseous tunnel.Flexor tendon repair under tumescent infiltration provides anesthesia and abloodless field, so that no tourniquet or sedation is needed.Aim of study. The goal of this study was to identify a surgical adjustmentand intraoperative total active movement examination of the repaired tendonso that no gapping is formed, and smooth gliding is obtained, avoiding tendonrupture and producing an optimal range of motion.Patients and method. From January 2016 to April 2017, 9 patients (17tendons), with a mean age of 31.8 years, presented within 3 to 14 days ofinjury to zone I or zone II of their flexor tendons. Tendon repair was doneunder tumescent infiltration (lidocaine 1% with adrenaline 1:200,000) only,with no tourniquet or sedation, and with an intraoperative total activemovement examination.Result. After 6 months of follow up, all the patients had excellent range ofmotion according to the Boyes outcome scale, and none showed signs ofpostoperative tendon rupture.Conclusion. Tumescent infiltration for flexor tendon repair allowsintraoperative surgical adjustment and total active movement examination,which will minimize postoperative rupture and adhesion. This procedure willalso facilitate the surgeon’s work by eliminating the need for generalanesthesia or sedation; however, this procedure is not applicable for children,major trauma, or those who are mentally challenged.

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