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<p>Extensor tendon repairs of the hand, particularly in zones VI–VIII, are frequently complicated by peritendinous adhesions, resulting in reduced tendon glide, extensor lag, and suboptimal functional recovery. This multicentre randomized controlled trial evaluated whether adjunctive high-purity type I collagen (HPTC) wrapping was associated with improved functional recovery and reduced adhesion-related morbidity following extensor tendon repair. In this multicentre randomized controlled trial, 60 adult patients with acute extensor tendon injuries in zones VI–VIII were randomized to undergo standard tendon repair with adjunctive HPTC wrap (n = 30) or standard repair alone (n = 30). Primary outcome was TAM at 8&#xa0;weeks, with extended follow-up assessments at 3- and 5-months evaluating durability of functional recovery. Secondary outcomes included QuickDASH scores, extensor lag, grip strength, adhesion-related functional limitation, and complications. Outcomes were assessed by blinded evaluators. Statistical analysis was performed using intention-to-treat principles. At eight weeks, mean TAM was significantly higher in the HPTC group compared with controls (232.4 ± 21.6 vs. 201.3 ± 26.8 degrees; <i>p</i> &lt; 0.001), with a large effect size (Cohen’s d = 1.30). The HPTC group demonstrated significantly lower QuickDASH scores, reduced extensor lag, and greater grip strength recovery (all <i>p</i> &lt; 0.001). Adhesion-related functional limitation occurred in 6.7% of patients in the HPTC group versus 30.0% in controls (<i>p</i> = 0.01). No collagen-related adverse events were observed. Extended follow-up demonstrated sustained functional benefit in the HPTC group through five months, including superior total active motion, lower QuickDASH disability scores, reduced extensor lag, greater grip strength recovery, and fewer secondary procedures related to adhesion formation. Adjunctive use of high-purity type I collagen wrap significantly improves early functional outcomes and reduces adhesion-related morbidity following extensor tendon repair. HPTC was associated with improved early and intermediate-term functional recovery and reduced adhesion-related morbidity, with longer follow-up with larger cohorts needed to confirm durability of these benefits.</p>

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High-purity type I collagen wrap is associated with improved functional recovery after extensor tendon repair: a multicentre randomized trial

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年8月4日

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  • Vijay Kumar,
  • Naveen Narayan,
  • Suhas Narayaswamy Gowda,
  • Sriranjani Srivatsa,
  • Bhavana Sundaram K

摘要

Extensor tendon repairs of the hand, particularly in zones VI–VIII, are frequently complicated by peritendinous adhesions, resulting in reduced tendon glide, extensor lag, and suboptimal functional recovery. This multicentre randomized controlled trial evaluated whether adjunctive high-purity type I collagen (HPTC) wrapping was associated with improved functional recovery and reduced adhesion-related morbidity following extensor tendon repair. In this multicentre randomized controlled trial, 60 adult patients with acute extensor tendon injuries in zones VI–VIII were randomized to undergo standard tendon repair with adjunctive HPTC wrap (n = 30) or standard repair alone (n = 30). Primary outcome was TAM at 8 weeks, with extended follow-up assessments at 3- and 5-months evaluating durability of functional recovery. Secondary outcomes included QuickDASH scores, extensor lag, grip strength, adhesion-related functional limitation, and complications. Outcomes were assessed by blinded evaluators. Statistical analysis was performed using intention-to-treat principles. At eight weeks, mean TAM was significantly higher in the HPTC group compared with controls (232.4 ± 21.6 vs. 201.3 ± 26.8 degrees; p < 0.001), with a large effect size (Cohen’s d = 1.30). The HPTC group demonstrated significantly lower QuickDASH scores, reduced extensor lag, and greater grip strength recovery (all p < 0.001). Adhesion-related functional limitation occurred in 6.7% of patients in the HPTC group versus 30.0% in controls (p = 0.01). No collagen-related adverse events were observed. Extended follow-up demonstrated sustained functional benefit in the HPTC group through five months, including superior total active motion, lower QuickDASH disability scores, reduced extensor lag, greater grip strength recovery, and fewer secondary procedures related to adhesion formation. Adjunctive use of high-purity type I collagen wrap significantly improves early functional outcomes and reduces adhesion-related morbidity following extensor tendon repair. HPTC was associated with improved early and intermediate-term functional recovery and reduced adhesion-related morbidity, with longer follow-up with larger cohorts needed to confirm durability of these benefits.