Background: Successful functional recovery following significant tendon injury requires both adequate surgical repair and postoperative rehabilitation. Unfortunately, these injuries are often debilitating and functional outcomes are often measured by simple tasks such as turning a key or changing clothing.
Methods: A retrospective case report of a 42 year old male concert pianist at The Royal Melbourne Hospital following a sheet metal laceration to his right hand involving multiple flexors.
Results: Intraoperatively the patient was found to have a little finger FDP avulsion with 30% bony loss and 100% lacerations of FDP and FDS to the remaining 3 fingers. The little finger FDP was repaired with a transosseous 3-0 nylon suture and stabilising axial K-wire. The remaining flexor tendons were repaired with a 2-0 ticron 4 strand Adelaide core suture and 4-0 nylon epitendinous suture. The patient was seen by the hand therapist 3 days postoperatively and commenced an early active range of motion protocol with 10 repetitions per hour and he continued to have regular review twice weekly. At 3 months post operatively the patient reported a pain free hand with near full range of motion. He scored 1 on the Disabilities of Arm, Shoulder and Hand questionnaire and has returned to playing the piano at concerts, reporting no significant change in his ability to perform.
Conclusion: To our knowledge this is the first report of a concert pianist returning to full function following a significant injury. In a sufficiently motivated patient, it demonstrates that robust tendon repairs and an aggressive early active mobilisation protocol can achieve excellent functional outcomes and near full recovery.