Faculty Collaboration Database

Sonographic differentiation of digital tendon rupture from adhesive scarring after primary surgical repair. J Hand Surg Am 2006 Apr;31(4):524-9

Date

04/25/2006

Pubmed ID

16632042

DOI

10.1016/j.jhsa.2006.01.003

Scopus ID

2-s2.0-33646495983 (requires institutional sign-in at Scopus site)   20 Citations

Abstract

PURPOSE: After the surgical repair of finger tendons finger range of motion may be limited by tendon rupture or adhesive scarring. Differentiating tendon rupture from adhesive scarring may be difficult clinically. Digital tendon sonography allows the evaluation of tendon integrity in a dynamic setting. Our objective was to determine if sonography could differentiate tendon rupture from adhesive scarring in patients who have had primary tendon repair.

METHODS: A retrospective review was performed of the radiographic, clinical, and surgical records of patients referred for finger sonography over a 2-year period. Twenty-eight digits in 21 patients were evaluated for finger tendon disruption after primary surgical repair. The diagnosis of complete tendon rupture was made when 1 or more of the following was identified: a gap separating the proximal and distal tendon margins, visualization of only the proximal tendon margin, or visualization of only the distal tendon margin. Adhesive scarring was diagnosed if the tendon appeared intact with abnormal peritendinous soft tissue abutting or partially encasing the tendon, with synovial sheath thickening, or with restricted tendon motion during dynamic evaluation.

RESULTS: Sonography correctly identified tendon rupture or adhesive scarring in 27 of 28 digits with 1 false-positive case (sensitivity, 100%; specificity, 93%; positive-predictive value, 93%; negative-predictive value, 100%; accuracy, 96%).

CONCLUSIONS: Sonography is an accurate modality for differentiating tendon rupture from adhesive scarring in patients with prior surgical tendon repair.

TYPE OF STUDY/LEVEL OF EVIDENCE: Diagnostic, Level I.

Author List

Budovec JJ, Sudakoff GS, Dzwierzynski WW, Matloub HS, Sanger JR

Authors

Joseph J. Budovec MD Professor in the Radiology department at Medical College of Wisconsin
William W. Dzwierzynski MD Professor in the Plastic Surgery department at Medical College of Wisconsin
Hani S. Matloub MD Professor in the Plastic Surgery department at Medical College of Wisconsin
James R. Sanger MD Professor in the Plastic Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Female
Finger Injuries
Humans
Male
Middle Aged
Postoperative Complications
Predictive Value of Tests
Range of Motion, Articular
Retrospective Studies
Rupture
Sensitivity and Specificity
Tendons
Tissue Adhesions
Ultrasonography