The accuracy of ultrasound in evaluating closed flexor tendon ruptures

This paper examines the accuracy of ultrasound (US) in identifying closed flexor tendon ruptures and ruptures following recent flexor tendon repair. Between January 2001 and December 2006, 80 patients were investigated. Rates of accuracy between clinical examination and US findings were compared using the Wilcoxon signed ranks test. The chi square test was used to compare differences in sonographic accuracy according to the nature and zone of injury as well as time elapsed between injury and subsequent US. The accuracy of US was found to be significantly higher than clinical examination alone (95% vs. 79%, Z = 2.00, p = 0.03). Time between injury and US was the only variable to significantly affect diagnostic accuracy. US findings were 100% accurate when imaging was undertaken between 1 and 7 days following injury, 88% accurate when undertaken on the same day as injury and 85.7% accurate when performed after 1 week (X ² = 6.4, p = 0.04). This retrospective study supports the notion that US can have a valuable role in the management of suspected closed flexor tendon ruptures and ruptures of recent flexor tendon repairs.