Continuous Double Knots Technique Versus the 4-Strand Modified Kessler Technique for Flexor Tendon Repair

Mostafa, Ahmed Ali; Ali, Ahmed Mohamed; Anany, Raafat Abdel Latif

doi:10.21608/zumj.2025.377140.3920

Continuous Double Knots Technique Versus the 4-Strand Modified Kessler Technique for Flexor Tendon Repair

Document Type : Original Article

Authors

¹ Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Zagazig University, Egypt

² Professor of plastic, Reconstructive, Hand and Microsurgery, Faculty of Medicine, Zagazig University, Egypt

³ Professor of Plastic Surgery, Faculty of Medicine, Zagazig University, Egypt

10.21608/zumj.2025.377140.3920

Abstract

Background. Flexor tendon injuries in the hand are common. surgeons, who are constantly striving for the optimal compromise between suture strength and early mobilization. This study aimed improving grip strength and total active movement in flexor tendon repair by utilizing and evaluating the efficacy of the continuous double knots technique versus the 4-strand modified Kessler technique regarding their clinical outcomes. Methods: This comparative randomized clinical trial included 30 patients who sustained acute flexor tendon injury, divided into two groups: Group 1; underwent flexor tendon repair using the continuous double knots technique. Group 2; underwent flexor tendon repair using the 4-strand modified Kessler technique. Results: 11 patients (73.3%) had good grip strength among group Ⅰ in comparison to only 5 patients (33.3%) among group II (P=0.028). There were 7 patients (47%) among group I were very satisfied with the operation in comparison to only 2 patients (13%) among group II and there were 3 patients (20%) among group I were satisfied with the operation in comparison to only 2 patients (13%) among group II (P=0.025). As regards to functional outcome according to Strickland score among studied patients, 7 patients (46.7%) among group I were excellent in comparison to 4 patient (26.67%) among group II, which was statistically significant (P=0.046). Conclusion: Using the continuous double knots technique then beginning early postoperative controlled active rehabilitation, leads to a better functional outcome, particularly in terms of total active motion, grip strength, as well as fewer complications.

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