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Hand Flexor Tendons Healing Assessment by Ultrasound After Primary Surgical Repair with and Without Intra Operative Injection of Platelet Rich Plasma (PRP)

Received: 4 March 2022     Accepted: 7 April 2022     Published: 14 April 2022
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Abstract

Introduction: Tendon injury represents a common cause of morbidity worldwide and of the commonest causes of disability especially among the worker group. Aims: Assessment of early healing progress and exclusion of any deviation in normal healing process using high resolution ultrasound regarding the changes in morphology and function of deep flexor tendon after surgical repair with and without PRP injection and correlate ultrasound picture with clinical outcome to reduce the post operative immobility period. Setting and design: Prospective, controlled study. Method and materials: We included 40 patients and compared between tendon healing and the early return to activities. 20 patients had an intraoperative PRP injection, while 20 others did not. Results: All repaired tendons in both groups shows a spindle like shape after 2 week. A persistent spindle shape of the tendon in ultrasound more than 12 weeks was related to significant improvement of tendon excursion and better dynamic movement of the repaired tendons (p < 0.05). The increased Power Doppler signal of the tendons more than 12 weeks was related to a significant increased tendon excursion and a so better dynamic movement of the fingers (p < 0.05). Ultrasound shows that PRP injection in primary tendon repair significantly improved the time needed to resume activities after tendon injuries, with a median of 6 weeks (SD 6-8) in Control Group and a median of 4 weeks (SD 4-6) in PRP Group. Post-operative pain was significantly improved in the second and third week in the PRP Group. Conclusions: The gray scale and Duplex ultrasound might be useful to rate and predict outcome of repaired tendon, reduce the post operative immobility period and rapid regain of hand function.

Published in International Journal of Medical Imaging (Volume 10, Issue 2)
DOI 10.11648/j.ijmi.20221002.11
Page(s) 10-15
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Ultrasound, Flexor Tendon Repair, Efficacy of PRP Injection

References
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    Mohamed Salah Elfeshawy, Mohamed Osama Ouf, Ahmed Rami Majeed. (2022). Hand Flexor Tendons Healing Assessment by Ultrasound After Primary Surgical Repair with and Without Intra Operative Injection of Platelet Rich Plasma (PRP). International Journal of Medical Imaging, 10(2), 10-15. https://doi.org/10.11648/j.ijmi.20221002.11

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    ACS Style

    Mohamed Salah Elfeshawy; Mohamed Osama Ouf; Ahmed Rami Majeed. Hand Flexor Tendons Healing Assessment by Ultrasound After Primary Surgical Repair with and Without Intra Operative Injection of Platelet Rich Plasma (PRP). Int. J. Med. Imaging 2022, 10(2), 10-15. doi: 10.11648/j.ijmi.20221002.11

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    AMA Style

    Mohamed Salah Elfeshawy, Mohamed Osama Ouf, Ahmed Rami Majeed. Hand Flexor Tendons Healing Assessment by Ultrasound After Primary Surgical Repair with and Without Intra Operative Injection of Platelet Rich Plasma (PRP). Int J Med Imaging. 2022;10(2):10-15. doi: 10.11648/j.ijmi.20221002.11

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  • @article{10.11648/j.ijmi.20221002.11,
      author = {Mohamed Salah Elfeshawy and Mohamed Osama Ouf and Ahmed Rami Majeed},
      title = {Hand Flexor Tendons Healing Assessment by Ultrasound After Primary Surgical Repair with and Without Intra Operative Injection of Platelet Rich Plasma (PRP)},
      journal = {International Journal of Medical Imaging},
      volume = {10},
      number = {2},
      pages = {10-15},
      doi = {10.11648/j.ijmi.20221002.11},
      url = {https://doi.org/10.11648/j.ijmi.20221002.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijmi.20221002.11},
      abstract = {Introduction: Tendon injury represents a common cause of morbidity worldwide and of the commonest causes of disability especially among the worker group. Aims: Assessment of early healing progress and exclusion of any deviation in normal healing process using high resolution ultrasound regarding the changes in morphology and function of deep flexor tendon after surgical repair with and without PRP injection and correlate ultrasound picture with clinical outcome to reduce the post operative immobility period. Setting and design: Prospective, controlled study. Method and materials: We included 40 patients and compared between tendon healing and the early return to activities. 20 patients had an intraoperative PRP injection, while 20 others did not. Results: All repaired tendons in both groups shows a spindle like shape after 2 week. A persistent spindle shape of the tendon in ultrasound more than 12 weeks was related to significant improvement of tendon excursion and better dynamic movement of the repaired tendons (p  Conclusions: The gray scale and Duplex ultrasound might be useful to rate and predict outcome of repaired tendon, reduce the post operative immobility period and rapid regain of hand function.},
     year = {2022}
    }
    

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  • TY  - JOUR
    T1  - Hand Flexor Tendons Healing Assessment by Ultrasound After Primary Surgical Repair with and Without Intra Operative Injection of Platelet Rich Plasma (PRP)
    AU  - Mohamed Salah Elfeshawy
    AU  - Mohamed Osama Ouf
    AU  - Ahmed Rami Majeed
    Y1  - 2022/04/14
    PY  - 2022
    N1  - https://doi.org/10.11648/j.ijmi.20221002.11
    DO  - 10.11648/j.ijmi.20221002.11
    T2  - International Journal of Medical Imaging
    JF  - International Journal of Medical Imaging
    JO  - International Journal of Medical Imaging
    SP  - 10
    EP  - 15
    PB  - Science Publishing Group
    SN  - 2330-832X
    UR  - https://doi.org/10.11648/j.ijmi.20221002.11
    AB  - Introduction: Tendon injury represents a common cause of morbidity worldwide and of the commonest causes of disability especially among the worker group. Aims: Assessment of early healing progress and exclusion of any deviation in normal healing process using high resolution ultrasound regarding the changes in morphology and function of deep flexor tendon after surgical repair with and without PRP injection and correlate ultrasound picture with clinical outcome to reduce the post operative immobility period. Setting and design: Prospective, controlled study. Method and materials: We included 40 patients and compared between tendon healing and the early return to activities. 20 patients had an intraoperative PRP injection, while 20 others did not. Results: All repaired tendons in both groups shows a spindle like shape after 2 week. A persistent spindle shape of the tendon in ultrasound more than 12 weeks was related to significant improvement of tendon excursion and better dynamic movement of the repaired tendons (p  Conclusions: The gray scale and Duplex ultrasound might be useful to rate and predict outcome of repaired tendon, reduce the post operative immobility period and rapid regain of hand function.
    VL  - 10
    IS  - 2
    ER  - 

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Author Information
  • Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

  • Department of Plastic and Burn Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

  • Department of Plastic and Burn Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

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