FLexor repAir and REhabilitation (FLARE) trial
A deep cut through the fingers is a common injury that damages the flexor tendons. They are smooth cords that help the fingers to bend. There are two flexor tendons in each finger, which join the muscles in the forearm to bones in the fingers. One tendon bends the middle knuckle, the other bends the fingertip. Flexor tendon injuries to the finger are more common in young adults.
The usual treatment is an operation to stitch the severed tendon ends together, followed by 12 weeks of rehabilitation. Repairing both tendons might give more strength but there is an increased risk of a bent finger with less movement. Repairing the one to the fingertip alone might give less strength but a better range of movement and is less expensive.
What we are doing
We are aiming to find out whether it is beneficial to patients and cost effective to just repair the tendon that bends the fingertip compared to repairing both. We will also assess whether it is beneficial to patients and cost effective to follow a rehab regime with the RMF splint, compared to a regime with a more restrictive dorsal blocking splint. We will also have information about how the treatments work in combination.
Patients will be randomly selected to have both tendons repaired, or just the one bending the fingertip.
We will measure outcomes at 6 weeks, 3 and 6 months after surgery. By 6 months, most patients will have finished rehab and been discharged. We will measure our main outcome at 6 months, using a patient questionnaire.
We will also conduct interviews to understand patient experience and acceptability of different anaesthetics, surgery and rehab.
Ms Emma Reay and Mr Matthew Gardiner
South Tees Hospitals NHS Foundation Trust
In set up