Controlled Active Motion Following Primary Flexor Tendon Repair: A Prospective Study Over 9 Years

Abstract

One hundred and thirty patients with 339 divided flexor tendons affecting 208 fingers were studied prospectively between 1988 and 1996, to assess a regime of primary flexor tendon suture and active postoperative motion, combined with a modified Kleinert dynamic traction splint. The tendon suture technique used was a high-strength multistrand technique using a modified Kessler core and a Halsted peripheral stitch. The results were influenced by the zone in which the tendon was divided, by the physiotherapy and to a lesser extent by the grade of surgeon operating. Overall results by Strickland criteria were 92% excellent or good, 7% fair and 1% poor. There were 43 complications in 31 patients including five zone 2 ruptures (5.7%) and one further rupture in zone 5. This method of flexor tendon repair requires good physiotherapy and splint-making capability but gives good results with minimal need for further surgery.

Clinical Outcomes Associated with Flexor Tendon Repair

“…Kitsis et al [25] treated 339 divided flexor tendons affecting 208 fingers. The tendons were repaired with a modified Kessler core and a Halsted peripheral stitch.…”

The biomechanical analysis of a tendon fixation device for flexor tendon repair

“…16 -19 In the clinical setting underestimation of forces after trauma and noncompliance during rehabilitation 20 may explain rupture rates up to 46% of the time, 9 with most between 5% and 10%. [3][4][5][6][7][8]14,15,[21][22][23][24][25] In addition to rupture early mobilization may lead to gapping with adhesion formation and diminished tendon glide and function.…”

Primary Pulley Enlargement in Zone 2 by Incision and Repair With an Extensor Retinaculum Graft

“…18,20,37 Outcomes might have been improved if the rehabilitation protocol included splinting of the IP joints in extension, institution of early active extension and flexion exercises, and referral to a hand therapist in all cases. 12,16,42 Beginning in the immediate postoperative period, an exercise regimen in the recovery room was done to motivate patients rather than to improve tendon healing.…”