Clinical Results of Flexor Tendon Repair in Zone II Using a Six-Strand Double-Loop Technique Compared with a Two-Strand Technique

Abstract

The clinical and functional results of 46 patients who underwent zone II flexor tendon repair using the Lim/Tsai technique combined with the Kleinert/Duran early active mobilisation regime and place and hold exercises were assessed. The results were compared with 25 patients who were treated by the modified Kessler technique and the Kleinert/Duran regime alone. After a follow-up of 8 to 17 weeks, the Lim/Tsai group had a better grip strength and a significantly better total active motion of 141 degrees compared with 123 degrees . The rupture rates (Lim/Tsai: 1/51; Kessler: 3/26) and the extension deficits were not statistically different in the two groups. However, the complication rate was significantly lower and the average time of treatment was significantly shorter in the Lim/Tsai group. These results support the use of the Lim/Tsai six-strand repair technique in zone II flexor tendon injuries and early active mobilisation without rubber-band traction.

Effectiveness of MicroRNA in Down-Regulation of TGF-β Gene Expression in Digital Flexor Tendons of Chickens: In Vitro and In Vivo Study

“…Early mobilization of the repaired tendon is effective in decreasing adhesions, although the motion does not eliminate adhesions and may rupture the repairs. [2][3][4][21][22][23] Numerous strategies were tested experimentally to combat adhesions; most either produced limited effects or had poor clinical applicability. A decade ago, Chang et al explored a novel approach of using antibody to neutralize TGF-␤1 to prevent adhesion formation.…”

Effect of A2 Pulley Release on Repaired Tendon Gliding Resistance and Rupture in a Chicken Model

“…Clinically, tendon repairs in this area were found to rupture more frequently than those in other areas of the digits. 16,29 Clinical reports have lacked clear documentation on whether a part of the major pulley was inadvertently vented, and whether the digits were actively flexed entirely early after surgery.…”

Effects of repetitive injections of hyaluronic acid on peritendinous adhesions after flexor tendon repair: a preliminary randomized, placebo-controlled clinical trial

“…[39,40] In order to solve these problems, many multi-strand tendon suture techniques have been described. [41,42] Experimental studies have shown that suture strength and resistance to repair site gap formation increase with the number of suture strands crossing the tendon repair site. [43][44][45] However, this makes the suture techniques more complex and increases the difficulty of using these configurations in clinical cases.…”