Influence of palmar plate injury on outcomes of zone 2 flexor tendon repair

This study investigates the impact of proximal interphalangeal joint palmar plate injury on outcomes of flexor tendon repair in zone 2, excluding cases with fractures or dislocations. A retrospective review of 47 digits in 45 patients treated between 2014 and 2022 was conducted, analysing surgical notes, ultrasound images and patient photographs. The palmar plate was injured in 17 digits and intact in 30. Outcomes were assessed using the Strickland criteria for active range of movement 6 months postoperatively. Our analysis revealed that palmar plate injuries significantly affect flexor tendon repair outcomes, with a normal palmar plate increasing the likelihood of excellent recovery by 18 times. Although previous studies indicate no consensus on the impact of flexor digitorum superficialis repair, our findings emphasize the importance of palmar plate integrity. Nerve injury and flexor digitorum superficialis repair did not show significant effects on recovery in this cohort. Our study provides valuable insights into the importance of the injury to the palmar plate.Level of evidence: III