Early active mobilisation following flexor tendon repair in zone 2.

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.

[1]  W H Akeson,et al.  Flexor tendon healing and restoration of the gliding surface. An ultrastructural study in dogs. , 1983, The Journal of bone and joint surgery. American volume.

[2]  T. Milward,et al.  The primary repair of digital flexor tendons. , 1982, British journal of plastic surgery.

[3]  D. McGrouther,et al.  Flexor Tendon Excursions in “No-Man's Land” , 1981, The Hand.

[4]  M. L. Mason,et al.  THE RATE OF HEALING OF TENDONS* AN EXPERIMENTAL STUDY OF TENSILE STRENGTH , 1941, Annals of surgery.

[5]  C. McDowell,et al.  Tendon healing: an experimental model in the dog. , 1977, The Journal of hand surgery.

[6]  I. Kessler,et al.  Primary repair without immobilization of flexor tendon division within the digital sheath. An experimental and clinical study. , 1969, Acta orthopaedica Scandinavica.

[7]  Austin D. Potenza,et al.  Tendon healing within the flexor digital sheath in the dog. , 1962, The Journal of bone and joint surgery. American volume.

[8]  H E Kleinert,et al.  Primary repair of flexor tendons. , 1973, The Orthopedic clinics of North America.

[9]  P. Tothill,et al.  BLOOD FLOW AND CLEARANCE IN TENDONS , 1984 .

[10]  J. M. Hunter,et al.  The effect of vincular injury on the results of flexor tendon surgery in zone 2. , 1985, The Journal of hand surgery.

[11]  S. Pappu,et al.  Fascia patch graft for a digital flexor sheath defect over primary tendon repair in the chicken. , 1986, The Journal of hand surgery.

[12]  M. Singer,et al.  Flexor tendon injuries: the results of primary repair. , 1988, Journal of hand surgery.

[13]  S. Woo,et al.  The Influence of Protected Passive Mobilization on the Healing of Flexor Tendons: A Biochemical and Microangiography Study , 1981, The Hand.

[14]  P. O. Jensen,et al.  Primary Flexor Tendon Repair in “No Man’s Land” , 1984, Journal of hand surgery.

[15]  G. Lister Incision and Closure of the Flexor Sheath During Primary Tendon Repair , 1983, The Hand.

[16]  H. Seradge Elongation of the repair configuration following flexor tendon repair. , 1983, The Journal of hand surgery.

[17]  A G Patwardhan,et al.  The effect of immediate constrained digital motion on the strength of flexor tendon repairs in chickens. , 1987, The Journal of hand surgery.

[18]  F. Rank,et al.  The Healing Process of Transplanted Digital Tendon Sheath Synovium: Experimental Autoradiographic Studies in Chickens , 1978 .

[19]  P M Weeks,et al.  Comparison of early passive motion and immobilization after flexor tendon repairs. , 1985, Plastic and reconstructive surgery.

[20]  W. Cooney,et al.  Quantification of regional blood flow to canine flexor tendons , 1984, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[21]  C. W. Chan,et al.  The Healing of Freeze-Dried Rabbit Flexor Tendon in a Synovial Fluid Environment , 1983, The Hand.

[22]  S. Woo,et al.  The importance of controlled passive mobilization on flexor tendon healing. A biomechanical study. , 1981, Acta orthopaedica Scandinavica.

[23]  J. W. Strickland,et al.  Digital function following flexor tendon repair in Zone II: A comparison of immobilization and controlled passive motion techniques. , 1980, The Journal of hand surgery.

[24]  P. Manske,et al.  The effect of flexor sheath integrity on nutrient uptake by chicken flexor tendons. , 1985, Clinical orthopaedics and related research.

[25]  C. Long Intrinsic-extrinsic muscle control of the fingers. Electromyographic studies. , 1968, The Journal of bone and joint surgery. American volume.

[26]  H. Becker Primary Repair Of Flexor Tendons In The Hand Without Immobilisation – Preliminary Report , 1978, The Hand.

[27]  P. Manske,et al.  Comparative nutrient pathways to the flexor profundus tendons in Zone II of various experimental animals. , 1983, The Journal of surgical research.

[28]  A. Ejeskär Flexor tendon repair in no-man's-land: results of primary repair with controlled mobilization. , 1984, The Journal of hand surgery.

[29]  P. Manske,et al.  Effect of flexor sheath integrity on tendon gliding: A biomechanical and histologic study , 1986, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[30]  A. Smith,et al.  A combined regimen of controlled motion following flexor tendon repair in "no man's land". , 1987, Plastic and reconstructive surgery.

[31]  Austin D. Potenza CRITICAL EVALUATION OF FLEXOR-TENDON HEALING AND ADHESION FORMATION WITHIN ARTIFICIAL DIGITAL SHEATHS. , 1963 .

[32]  G. Lundborg Experimental flexor tendon healing without adhesion formation--a new concept of tendon nutrition and intrinsic healing mechanisms. A preliminary report. , 1976, The Hand.

[33]  P. Manske,et al.  The effect of flexor sheath integrity on nutrient uptake by primate flexor tendons. , 1986, The Journal of hand surgery.

[34]  G. Lundborg,et al.  The role of the synovial fluid and tendon sheath for flexor tendon nutrition. An experimental tracer study on diffusional pathways in dogs. , 1980, Scandinavian journal of plastic and reconstructive surgery.

[35]  G. Brunelli,et al.  Slip-knot flexor tendon suture in Zone II allowing immediate mobilisation. , 1983, The Hand.

[36]  R. Gelberman,et al.  Flexor Tendon Healing , 1985, Journal of hand surgery.

[37]  W. Akeson,et al.  Flexor tendon repair in vitro: A comparative histologic study of the rabbit, chicken, dog, and monkey , 1984, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[38]  R. Gelberman,et al.  Intrinsic flexor-tendon repair. A morphological study in vitro. , 1984, The Journal of bone and joint surgery. American volume.