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CC BY-NC-ND 4.0 · Indian J Plast Surg 2023; 56(06): 480-487
DOI: 10.1055/s-0043-1775864
Systematic Review

Evaluation of Outcome Measures of Zone V Flexor Tendon Injury: A Systematic Review

Autor*innen

  • Iris Cardoz Lobo 

    1   Department of Plastic Surgery, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, Maharashtra, India

  • Sonali Manek 

    2   Physiotherapy School and Centre, Topiwala National Medical College and B Y L Nair Charitable Hospital, Mumbai Central, Mumbai, Maharashtra, India

  • Krutika Bhosale 

    2   Physiotherapy School and Centre, Topiwala National Medical College and B Y L Nair Charitable Hospital, Mumbai Central, Mumbai, Maharashtra, India

  • Chhaya Verma 

    2   Physiotherapy School and Centre, Topiwala National Medical College and B Y L Nair Charitable Hospital, Mumbai Central, Mumbai, Maharashtra, India

  • Maksud Devale 

    1   Department of Plastic Surgery, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, Maharashtra, India

  • Aditi Parekh 

    2   Physiotherapy School and Centre, Topiwala National Medical College and B Y L Nair Charitable Hospital, Mumbai Central, Mumbai, Maharashtra, India

  • Priyanka Kerketta 

    1   Department of Plastic Surgery, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, Maharashtra, India
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Abstract

Background Flexor tendon injury zone V is a multicomponent soft tissue injury involving tendons, nerves, and vessels. Outcome assessment of repair thus requires evaluation of the hand as a whole rather than solely evaluating tendon function. The purpose of this Preferred Reporting Items for Systematic Reviews and Meta-Analyses -compliant systematic review was to identify and assess the components of outcome measures used in flexor zone V.

Methods A total of 3,761 studies were retrieved from four databases (PubMed, ProQuest, Cochrane Central, and Google Scholar). These studies were then screened for inclusion using a validated screening form. Fifteen articles fulfilling the eligibility criteria were included in the review. Subsequently, the included studies were assessed for methodological quality using the Joanna Brigg Institute tool.

Results Out of the 15 studies, 11 were case series, 3 were cross-sectional studies, and 1 was a randomized controlled trial. Out of 15 included studies, 13 were of low risk, whereas 2 studies suggested moderate risk when assessed for methodological quality using the Joanna Brigg Institute tool. Eight outcome measures were identified, out of which the most frequently used were Total Active Motion by the American Society for Surgery of Hand (TAM-ASSH) and Noaman's criteria. Our study found that Noaman's criteria assessed sensory-motor function and finger deformity in addition to the range of motion (ROM), which was found to be assessed by all the other outcome measures.

Conclusion We concluded that although Buck-Gramcko criteria is well suited for the ROM evaluation, Noaman's criteria, a recently developed outcome measure used exclusively for combined injuries in zone V, took into consideration the implications of nerve injury along with tendon function. Although being specifically designed for combined injuries of tendons, nerves, and vessels in zone V, there is a lack of usage of Noaman's in the literature. There still exists a lack of a consistent and appropriate choice of outcome measure.

Keywords

zone V - spaghetti wrist - flexor tendon - outcome measures - functional outcome

PROSPERO Registration: CRD42022329391

The protocol was submitted on April 30, 2022 according to PRISMA (2020) guidelines and was approved on May 10, 2022. The review was conducted from April 30 to November 24, 2022.


Presentation

This review was awarded first rank in paper presentation section of the SHTICON 2022, 9th Annual Conference of the Society for Hand Therapy, India in collaboration with 45th Annual Conference of the Indian Society for Surgery of the Hand. The conference was held on 7 to 8 October 2022 in Jaipur, Rajasthan.


Author Contributions

C.V. was involved in formulating the idea of this systematic review, resolving disagreements on the inclusion of studies, writing of the manuscript, and expert guidance throughout the review process. M.D. initiated the idea of this systematic review, resolving disagreements on the inclusion of studies, and writing of the manuscript. K.B. was involved in drafting the review, literature search, screening process, risk of bias assessment, and writing of the final manuscript. I.C. was responsible for drafting the review, screening process, and writing of the manuscript. S.M. was involved in drafting the review protocol, literature search, data extraction from the studies included, and writing of the manuscript. P.K. was involved in drafting the review protocol, extracting data, and suggestions for writing the manuscript. A.P. was involved in drafting the review protocol, assessing the risk of bias, and writing of the manuscript.


Supplementary Material



Publikationsverlauf

Artikel online veröffentlicht:
08. November 2023

© 2023. Association of Plastic Surgeons of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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