Current practice of primary flexor tendon repair: a global view.

In this article, a group of international leaders in tendon surgery of the hand provide details of their current methods of primary flexor tendon repair. They are from recognized hand centers around the world, from which major contributions to the development of methods for flexor tendon repair have come over the past 2 decades. Changes made since the early 1990s regarding surgical methods and postoperative care for the flexor tendon repair are also discussed. Current practice methods used in the leading hand centers are summarized, and key points in providing the best possible clinical outcomes are outlined.

[1]  W. J. Kacena,et al.  The effect of increased peripheral suture purchase on the strength of flexor tendon repairs. , 2003, The Journal of hand surgery.

[2]  E. Vögelin,et al.  Clinical primary flexor tendon repair and rehabilitation: The Bern Experience , 2012 .

[3]  P. Nasser,et al.  The effects of core suture purchase on the biomechanical characteristics of a multistrand locking flexor tendon repair: a cadaveric study. , 2010, The Journal of hand surgery.

[4]  Yi Cao,et al.  Resistance to motion of flexor tendons and digital edema: An in vivo study in a chicken model. , 2006, The Journal of hand surgery.

[5]  R. Meffert,et al.  Biomechanical evaluation of flexor tendon repair using barbed suture material: a comparative ex vivo study. , 2011, The Journal of hand surgery.

[6]  K. An,et al.  Gliding Resistance of the Flexor Pollicis Longus Tendon after Repair: Does Partial Excision of the Oblique Pulley Affect Gliding Resistance? , 2006, Plastic and reconstructive surgery.

[7]  E Diao,et al.  Effect of peripheral suture depth on strength of tendon repairs. , 1996, The Journal of hand surgery.

[8]  W. Walsh,et al.  Adhesion formation after flexor tendon repair: a histologic and biomechanical comparison of 2- and 4-strand repairs in a chicken model. , 2004, The Journal of hand surgery.

[9]  D. Elliot,et al.  Primary flexor tendon surgery: the search for a perfect result. , 2013, Hand clinics.

[10]  J B Tang,et al.  Biomechanical Evaluation of a Four-Strand Modification of the Tang Method of Tendon Repair , 2005, Journal of hand surgery.

[11]  W. Walsh,et al.  Influence of locking stitch size in a four-strand cross-locked cruciate flexor tendon repair. , 2011, The Journal of hand surgery.

[12]  P C Amadio,et al.  Suture techniques with high breaking strength and low gliding resistance: Experiments in the dog flexor digitorum profundus tendon , 2001, Acta orthopaedica Scandinavica.

[13]  C. Verdan,et al.  Tendon Surgery of the Hand , 1980 .

[14]  E. Diao,et al.  A device for zone-II flexor tendon repair. Surgical technique. , 2006, The Journal of bone and joint surgery. American volume.

[15]  S L Woo,et al.  Flexor tendon repair , 2002, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[16]  R. Xie,et al.  Digital Oedema, Adhesion Formation and Resistance to Digital Motion after Primary Flexor Tendon Repair , 2008, The Journal of hand surgery, European volume.

[17]  W. Walsh,et al.  Biomechanical evaluation of flexor tendon repair using barbed suture material: a comparative ex vivo study. , 2011, The Journal of hand surgery.

[18]  Matthew J. Silva,et al.  Intrasynovial Flexor Tendon Repair: An Experimental Study Comparing Low and High Levels of in Vivo Force During Rehabilitation in Canines , 2001, The Journal of bone and joint surgery. American volume.

[19]  S. Woo,et al.  The effects of multiple-strand suture methods on the strength and excursion of repaired intrasynovial flexor tendons: a biomechanical study in dogs. , 1998, The Journal of hand surgery.

[20]  Jin-bo Tang.  Indications, Methods, Postoperative Motion and Outcome Evaluation of Primary Flexor Tendon Repairs in Zone 2 , 2007, The Journal of hand surgery, European volume.

[21]  S. Wolfe,et al.  A biomechanical comparison of multistrand flexor tendon repairs using an in situ testing model. , 2000, The Journal of hand surgery.

[22]  D. Elliot.  Primary Flexor Tendon Repair – Operative Repair, Pulley Management and Rehabilitation , 2002, Journal of hand surgery.

[23]  K. An,et al.  The effects of oblique or transverse partial excision of the A2 pulley on gliding resistance during cyclic motion following zone II flexor digitorum profundus repair in a cadaveric model. , 2012, The Journal of hand surgery.

[24]  Y. F. Wu,et al.  Biomechanical comparisons of four-strand tendon repairs with double-stranded sutures: effects of different locks and suture geometry , 2011, The Journal of hand surgery, European volume.

[25]  J. Tang,et al.  Core suture purchase affects strength of tendon repairs. , 2005, The Journal of hand surgery.

[26]  E. Diao,et al.  Device for zone-II flexor tendon repair. A multicenter, randomized, blinded, clinical trial. , 2005, The Journal of bone and joint surgery. American volume.

[27]  E. Vögelin,et al.  Clinical Results of Flexor Tendon Repair in Zone II Using a Six-Strand Double-Loop Technique Compared with a Two-Strand Technique , 2008, The Journal of hand surgery, European volume.

[28]  K. An,et al.  Resection of the flexor digitorum superficialis reduces gliding resistance after zone II flexor digitorum profundus repair in vitro. , 2002, Journal of Hand Surgery-American Volume.

[29]  Kai-Nan An,et al.  Effect of Synergistic Motion on Flexor Digitorum Profundus Tendon Excursion , 2002, Clinical orthopaedics and related research.

[30]  Matthew J. Silva,et al.  Intrasynovial flexor tendon repair: A biomechanical study of variations in suture application in human cadavera , 2012, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[31]  M. Sandow,et al.  Active mobilisation following single cross grasp four-strand flexor tenorrhaphy (Adelaide repair) , 2011, The Journal of hand surgery, European volume.

[32]  K. An,et al.  Digital resistance and tendon strength during the first week after flexor digitorum profundus tendon repair in a canine model in vivo. , 2004, The Journal of bone and joint surgery. American volume.

[33]  J. Tang,et al.  Effects of tension across the tendon repair site on tendon gap and ultimate strength. , 2012, The Journal of hand surgery.

[34]  D. Lalonde,et al.  Wide-awake flexor tendon repair and early tendon mobilization in zones 1 and 2. , 2013, Hand clinics.

[35]  Steve K. Lee.  Modern tendon repair techniques. , 2012, Hand clinics.

[36]  J. Tang,et al.  Clinical outcomes associated with flexor tendon repair. , 2005, Hand clinics.

[37]  D. Shi,et al.  Double and Multiple Looped Suture Tendon Repair , 1994, Journal of hand surgery.

[38]  K. Tsuge,et al.  Repair of flexor tendons by intratendinous tendon suture. , 1977, The Journal of hand surgery.