Early active mobilisation following flexor tendon repair in zone 2

Abstract

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.

Surface Treatment of Flexor Tendon Autografts with Carbodiimide-Derivatized Hyaluronic Acid<sbt aid="1047845">An in Vivo Canine Model</sbt>

“…The measurement of work of flexion continued until the distal interphalangeal joint angle reached 40° of flexion, on the basis of a previously published study 44 . Work-of-flexion data were calculated from the tendon displacement versus loading curve during digital flexion and then were normalized (divided) by the total proximal interphalangeal and distal interphalangeal joint motion angle at the point where the distal interphaangeal joint reached 40°4 4 .…”

“…Although there has been a marked improvement in the outcomes after flexor tendon laceration with new regimens of direct repair and postoperative controlled mobilization [1][2][3][4][5] , adhesion formation continues to be a difficult problem after flexor tendon repair, especially in zone II [6][7][8][9][10][11] . A tendon graft is still indicated when a flexor tendon repair fails or when tendon rupture or tendon transfer requires elongation of the muscle-tendon unit 10,[12][13][14] .…”

Tendon and Ligament Tissue Engineering, Healing and Regenerative Medicine

“…For hand flexor tendons, there are 3 main methods. Firstly, there is active extension with rubber band flexion, also called the active extensionpassive flexion method [141]. Secondly there is passive motion method, which uses a range of 3-5mm of passive motion in the involved tendon and then lastly there is controlled passive motion with the patient actively flexing the digit rather than someone else [141].…”

Early mobilization compared with immobilization after repair of a flexor tendon injury in children: A retrospective long time follow-up

“…The strategy of flexor tendon rehabilitation was decided by the surgeon according to the expected cooperation of the patient and parents. Active early mobilization (n=17) was initiated at 3-5 days after surgery, according to the protocol used for adults at the department and in detail described by Small et al [16]. In 10 patients the hand and wrist of the patient were immobilized in a cast for 3-4 weeks, where the child was allowed to use the hand freely.…”