{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T19:16:59Z","timestamp":1790623019071,"version":"4.1.0"},"reference-count":27,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Handchir Mikrochir Plast Chir"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background Several surgical techniques have been reported for flexor\n                    tendon zone 1a-b lacerations without a clear consensus on the gold standard\n                    treatment. The purpose of this multicentre study was to measure the outcomes of\n                    zone 1a-b flexor tendon injuries treated with a pull-out suture (POS) versus\n                    direct suture (DS) technique.<\/jats:p><jats:p>\n          Patients and Methods Fifteen patients were treated with the pull-out\n                    technique and 22 patients with a direct suture technique between 2014 and 2020.\n                    The controlled active motion (CAM) regimen protocol and a standardised follow-up\n                    schedule were used in both groups. Data on the demographics, surgery, and\n                    treatment characteristics were collected at baseline as well as at week 6 and 13\n                    post-operatively. The primary outcome measurement was the complication rate.\n                    Secondary outcome measurements were reoperation rate, finger range of motion\n                    (ROM), strength as well as patient satisfaction.<\/jats:p><jats:p>\n          Results The patient age ranged from 18 to 75 years in both groups with all\n                    patients having a complete FDP lesion after a clean-cut injury. The complication\n                    rate was 41% in the POS group and 16% in the DS group. The\n                    reoperation rate was 29% in the POS group and 8% in the DS\n                    group. Significant between-group differences in favour of the DS group were\n                    found in the passive DIP and passive PIP+DIP ROM at week 6 and week 13.\n                    Mean hand strength was 28.7 (11.6) kg in the POS group at week 13 and 21.3 (7.9)\n                    kg in the DS group. This difference was statistically significant\n                    (p=0.012) with a medium effect size (r=-0.41). Average patient\n                    satisfaction at week 13 was 7.5 (2.2) points in the POS and 7.7 (1.3) points in\n                    the DS group. The difference between groups was not significant\n                    (p=0.839).<\/jats:p><jats:p>\n          Conclusion This register-based study demonstrates lower complication and\n                    reoperation rates with the direct suture approach compared with a pull-out\n                    button technique. Although clinical results were similar between the two surgery\n                    techniques at week 13 post-surgery, a direct suture approach should always be\n                    attempted whenever possible. If necessary, other local structures should be\n                    included to increase suture strength and allow for early active motion\n                    rehabilitation regimens.<\/jats:p>","DOI":"10.1055\/a-2217-7944","type":"journal-article","created":{"date-parts":[[2024,2,15]],"date-time":"2024-02-15T23:48:40Z","timestamp":1708040920000},"page":"342-349","source":"Crossref","is-referenced-by-count":2,"title":["Pull-out vs. suture in zone Ia-Ib flexor tendon injuries: clinical\n                    results from a multicentre cohort study"],"prefix":"10.1055","volume":"56","author":[{"given":"Nicola","family":"Keller","sequence":"additional","affiliation":[{"name":"Plastic surgery and Hand surgery, University Hospital Z\u00fcrich,\n                    Z\u00fcrich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4005-0331","authenticated-orcid":false,"given":"Marco","family":"Guidi","sequence":"additional","affiliation":[{"name":"Centro Manoegomito, Clinica Ars Medica, Gravesano,\n                    Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5426-1762","authenticated-orcid":false,"given":"Bernadette","family":"Tobler- Ammann","sequence":"additional","affiliation":[{"name":"Plastic Surgery and Hand Surgery, Inselspital University Hospital Bern,\n                    Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3846-8915","authenticated-orcid":false,"given":"Vera","family":"Beckmann-Fries","sequence":"additional","affiliation":[{"name":"Department of Plastic surgery and Hand Surgery, University Hospital\n                    Z\u00fcrich, Z\u00fcrich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6928-6973","authenticated-orcid":false,"given":"Lorena","family":"Schrepfer","sequence":"additional","affiliation":[{"name":"Department of Plastic surgery and Hand surgery, University Hospital\n                    Basel, Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7926-3502","authenticated-orcid":false,"given":"Alexandre","family":"Kaempfen","sequence":"additional","affiliation":[{"name":"Plastic, Reconstructive, Aesthetic and Hand Surgery,\n                    Universit\u00e4tsspital Basel, Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2491-3985","authenticated-orcid":false,"given":"Esther","family":"V\u00f6gelin","sequence":"additional","affiliation":[{"name":"Plastic Surgery and Hand Surgery, Inselspital University Hospital Bern,\n                    Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4372-0561","authenticated-orcid":false,"given":"Maurizio","family":"Calcagni","sequence":"additional","affiliation":[{"name":"Plastic surgery and Hand surgery, University Hospital Z\u00fcrich,\n                    Z\u00fcrich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2024,2,15]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1054\/jhsb.1999.0319","article-title":"Primary Flexor Tendon Repair In Zone 1","volume":"25","author":"N S Moiemen","year":"2000","journal-title":"The Journal of Hand Surgery: British & European\n                    Volume"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/S0363-5023(87)80156-9","article-title":"Permissible limits of flexor digitorum profundus tendon advancement--an anatomic\n          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J\n                    Hand Surg Am","volume":"45","author":"M B Geary","year":"2020"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/S0266-7681(96)80146-X","article-title":"A new technique of attachment of flexor tendons to the distal phalanx without a\n                    button tie-over","volume":"21","author":"M K Sood","year":"1996","journal-title":"J Hand Surg Br"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1007\/s12593-013-0100-8","article-title":"Comparison of Transverse Intraosseous Loop Technique and Pull Out Suture for\n                    Reinsertion of the Flexor Digitorum Profundus tendon. A Retrospective Study","volume":"5","author":"I Z Rig\u00f3","year":"2013","journal-title":"Journal of hand and microsurgery"}],"container-title":["Handchirurgie \u00b7 Mikrochirurgie \u00b7 Plastische Chirurgie"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2217-7944.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T16:42:22Z","timestamp":1730824942000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2217-7944"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,15]]},"references-count":27,"journal-issue":{"issue":"05","published-online":{"date-parts":[[2024,9,27]]},"published-print":{"date-parts":[[2024,9]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2217-7944","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0722-1819","1439-3980"],"issn-type":[{"value":"0722-1819","type":"print"},{"value":"1439-3980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,15]]}}}