Ramil M. Bonifacio
Jose B. Lingad Memorial General Hospital , PhilippinesPresentation Title:
Four-strand modified kessler versus cruciate technique for repair of zone two flexor tendon injuries: A randomized controlled trial
Abstract
Background: This is the first double-blinded randomized study in which the four-strand modified Kessler and the four-strand cruciate technique were compared in a series of zone II flexor tendon injuries in patients of working age (19–60 years old).
Objective: To compare the functional outcomes of zone II flexor tendon repair with the four-core modified Kessler versus the four-core cruciate technique done at our institution’s Hand Clinic.
Methodology: This double-blinded randomized controlled trial was conducted from September 2022 to August 2023. The sample population consisted of eight fingers of eight patients who sustained traumatic zone II flexor tendon lacerations. Statistical analysis was made between the functional outcomes using the Strickland formula at the fourth, sixth, and eighth weeks, and the FIL-DASH (Disabilities of the Arm, Shoulder, and Hand - Filipino translation) score at the third, and sixth months postoperatively.
Result: At weeks four, six, & eight post-operatively, Strickland scores in the four-strand cruciate group were significantly higher than those in the four-strand modified Kessler group (p <0.02, p <0.03 and p <0.02). FIL-DASH scores at three and six months did not differ significantly between the groups.
Conclusion: The four-core cruciate technique resulted in significantly better short-term functional outcomes than the four-core modified Kessler technique. More studies are needed to improve on these findings.
Keywords: Modified-Kessler, Cruciate, Functional Outcome, FIL-DASH, Double-Blinded Randomized Controlled Trial, Flexor tendon injury
Biography
Ramil M Bonifacio is a distinguished orthopedic surgeon recognized for his extensive contributions to clinical practice and research. He completed his residency in Orthopaedics at Jose B. Lingad Memorial General Hospital (JBLMGH), a premier tertiary government hospital in the Philippines renowned for its comprehensive healthcare services and pioneering healthcare standards. Currently, he serves as a visiting Orthopedics Consultant at various hospitals while pursuing a Master of Management major in Hospital Administration. Bonifacio has a robust research portfolio, recently presenting as a guest international podium researcher at the Hong Kong Society of Surgery of the Hands in March 2024. His groundbreaking research, including the publication "Four-Strand Modified Kessler versus Cruciate Technique for Repair of Zone Two Flexor Tendon Injuries: A Randomized Controlled Trial" in the Philippine Journal of Orthopaedics, has garnered significant recognition. Notably, he was awarded the title of Research Grand Champion at the 9th Central Luzon Health Research Forum Competition in April 2024. As an active contributor to the advancement of orthopedic science, Bonifacio’s work embodies a commitment to improving orthopedic care and health administration. His dedication to continuous education and clinical excellence underlines his leadership in the field.
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