scholarly journals A review of current concepts in flexor tendon repair: physiology, biomechanics, surgical technique and rehabilitation.

2015 ◽  
Vol 7 (4) ◽  
Author(s):  
Rohit Singh ◽  
Ben Rymer ◽  
Peter Theobald ◽  
Peter B.M. Thomas
Keyword(s):  
Flexor Tendon ◽  
Primary Repair ◽  
Functional Anatomy ◽  
Tendon Repair ◽  
Hand Surgery ◽  
Suture Repair ◽  
Flexor Tendon Repair ◽  
Flexor Tendon Injuries ◽  
No Man's Land ◽  
American Society

Historically, the surgical treatment of flexor tendon injuries has always been associated with controversy. It was not until 1967, when the paper entitled Primary repair of flexor tendons in no man’s land was presented at the American Society of Hand Surgery, which reported excellent results and catalyzed the implementation of this technique into world-wide practice. We present an up to date literature review using PubMed and Google Scholar where the terms flexor tendon, repair and rehabilitation were used. Topics covered included functional anatomy, nutrition, biomechanics, suture repair, repair site gapping, and rehabilitation. This article aims to provide a comprehensive and complete overview of flexor tendon repairs.

Early Active Mobilisation Following Flexor Tendon Repair in Zone 2

1989 ◽  
Vol 14 (4) ◽  
pp. 383-391
Author(s):  
J. O. SMALL ◽  
M. D. BRENNEN ◽  
J. COLVILLE
Keyword(s):  
Flexor Tendon ◽  
Tendon Repair ◽  
Tendon Injuries ◽  
Grading System ◽  
Flexor Tendon Repair ◽  
Active Range Of Motion ◽  
Flexor Tendon Injuries ◽  
American Society ◽  
A Prospective Study ◽  
Similar Programme

In a prospective study, 114 patients with 138 zone 2 flexor tendon injuries were treated over a three-year period. Early active mobilisation of the injured fingers was commenced within 48 hours of surgery. 98 patients (86%) were reviewed at least six months after operation. Using the grading system recommended by the American Society for Surgery of the Hand, the active range of motion recovered was graded excellent or good in 77% of digits, fair in 14% and poor in 9%. Dehisence of the repair occurred in 11 digits (9.4%) and in these an immediate re-repair followed by a similar programme of early active mobilisation resulted in an excellent or good outcome in seven digits.

scholarly journals Active Mobilisation after Flexor Tendon Repair: Comparison of Results following Injuries in Zone 2 and other Zones

2005 ◽  
Vol 13 (2) ◽  
pp. 158-163 ◽  
Author(s):  
LK Hung ◽  
KW Pang ◽  
PLC Yeung ◽  
L Cheung ◽  
JMW Wong ◽  
...  
Keyword(s):  
Flexor Tendon ◽  
Tendon Repair ◽  
Clinical Results ◽  
Range Of Movement ◽  
Flexor Tendon Repair ◽  
Active Motion ◽  
Day Range ◽  
Flexor Tendon Injuries ◽  
Total Active Motion ◽  
American Society

Purpose. To prospectively study the role of active mobilisation after flexor tendon repair. Methods. The standard modified Kessler's technique was used to repair 46 digits in 32 patients with flexor tendon injuries. Early active mobilisation of the repaired digit was commenced on the third postoperative day. Range of movement was monitored and recovery from injury in zone 2 was compared with injury in other zones. Results. There were 24 and 22 injuries in zone 2 and other zones respectively. The total active motion score of the American Society for Surgery of the Hand was measured. Patients with zone-2 injuries achieved similar results to those with other-zone injuries apart from a 3-week delay in recovery. The final results were good to excellent in 71% and 77% of zone-2 and other-zone cases respectively (p<0.05). There were 2 ruptures in zone-2 and one rupture in zone-3 repairs (6.5%). Conclusion. Preliminary results of this study showed that active mobilisation following flexor tendon repair provides comparable clinical results and is as safe as conventional mobilisation programmes although recovery in patients with zone-2 injury was delayed.

Flexor Tendon Injuries: The Results of Primary Repair

1988 ◽  
Vol 13 (3) ◽  
pp. 269-272
Author(s):  
M. SINGER ◽  
S. MALOON
Keyword(s):  
Flexor Tendon ◽  
Primary Repair ◽  
Hand Surgery ◽  
Tendon Injury ◽  
Tendon Injuries ◽  
Flexor Digitorum Profundus ◽  
Flexor Tendon Injuries ◽  
No Man's Land ◽  
Flexor Pollicis Longus Tendon ◽  
Flexor Digitorum

This study is a critical analysis of results obtained following primary repair and post-operative controlled mobilisation of flexor tendon injuries which were treated by registrars with up to six months experience in hand surgery. 70 (55%) of 125 patients who underwent repair of a complete flexor digitorum profundus or flexor pollicis longus tendon injury during a 14-month period attended for review and these had a total of 140 injured digits. 93 (67%) were rated Lister’s standards as an “excellent” or “good” result. 39 (28%) occurred in “no man’s land” (Zone 2) and only 19 (49%) in this area were rated “excellent” or “good”. Isolated flexor digitorum superficialis tendon injuries have been excluded from this study, as have partial tendon injuries.

Methods of Evaluation of the Functional Results of Flexor Tendon Repair of the Fingers

1985 ◽  
Vol 10 (1) ◽  
pp. 60-61 ◽  
Author(s):  
A. B. NIELSEN ◽  
P. Ø. JENSEN
Keyword(s):  
Functional Outcome ◽  
Standard Method ◽  
Flexor Tendon ◽  
Tendon Repair ◽  
Functional Results ◽  
Functional Evaluation ◽  
Flexor Tendon Repair ◽  
Methods Of Evaluation ◽  
Method Of Measurement ◽  
No Man's Land

The methods used by Buck-Gramcko, Kleinert and Tsuge in evaluating the functional results of flexor tendon repair were each applied to assess the functional outcome in sixty-seven fingers where both tendons had been severed in “no man's land”. The method of Buck-Gramcko gave the highest rating, and the three methods showed evident differences in the results of evaluation after surgery. The study suggests a need for one standard method of measurement and recording, if a comparison of results after flexor tendon repair is to be of value. We found that the method of Buck-Gramcko incorporated the most essential features in the functional evaluation.

Flexor tendon repair: recent changes and current methods

2021 ◽  
pp. 175319342110537
Author(s):  
Jin Bo Tang ◽  
Donald Lalonde ◽  
Leila Harhaus ◽  
Ahmed Fathy Sadek ◽  
Koji Moriya ◽  
...  
Keyword(s):  
Functional Recovery ◽  
Flexor Tendon ◽  
Tendon Repair ◽  
Hand Surgery ◽  
Past Experience ◽  
Current Status ◽  
Flexor Tendon Repair ◽  
Clinical Methods

The current clinical methods of flexor tendon repair are remarkably different from those used 20 years ago. This article starts with a review of the current methods, followed by presentation of past experience and current status of six eminent hand surgery units from four continents/regions. Many units are using, or are moving toward using, the recent strong (multi-strand) core suture method together with a simpler peripheral suture. Venting of the critical pulleys over less than 2 cm length is safe and favours functional recovery. These repair and recent motion protocols lead to remarkably more reliable repairs, with over 80% good or excellent outcomes achieved rather consistently after Zone 2 repair along with infrequent need of tenolysis. Despite slight variations in repair methods, they all consider general principles and should be followed. Outcomes of Zone 2 repairs are not dissimilar to those in other zones with very low to zero incidence of rupture.

Primary Repair Of Flexor Tendons In The Hand Without Immobilisation – Preliminary Report

HAND ◽  
1978 ◽  
Vol os-10 (1) ◽  
pp. 37-47 ◽  
Author(s):  
Hilton Becker
Keyword(s):  
Blood Supply ◽  
Preliminary Report ◽  
Suture Material ◽  
Flexor Tendon ◽  
Primary Repair ◽  
Tendon Repair ◽  
Gap Formation ◽  
Flexor Tendon Repair ◽  
New Approach ◽  
Flexor Tendons

summary A new approach to the problem of flexor tendon repair within the fibro-osseous canal is presented. Using a technique of bevelling the tendon ends and suturing with a fine suture material, under magnification, a sufficiently strong junction is obtained, which enables immediate active mobilisation without strangulation of the blood supply. The junction can resist gap formation up to tensions of 4 Kg. It is postulated that under these conditions tendon nutrition is minimally interfered with, adhesions do not form, and the tendon heals by its own intrinsic healing ability.

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