Prognostic indicators affecting functional outcome in Zone II flexor tendon repairs

Abstract

Background: Advances in surgical technique and rehabilitation have transformed zone II flexor tendon injuries from an inoperable no man's land to a standard surgical procedure. Despite these advances, many patients develop a substantial range of motion limiting adhesions after primary flexor tendon repair. To analyze the prognostic indicators, which influence the functional outcome in Zone II Flexor tendon injuries in fingers.Methods: 21 patients with 28 Zone II Flexor Tendon Injuries who presented to us within 24 hours since the injury and repaired primarily were studied. Postoperatively hand is immobilized in a dorsal POP splint for 3 weeks. Pulsed ultrasound therapy was started on day 7, and continued upto 8 weeks.Results: In the FFS Repaired group combined excellent and good results were obtained in 80% of patients. Zone II A good and excellent results were obtained in 81% of patients, whereas in II B in was 91%. In Zone II C60% of excellent and good results were obtained.Conclusions: High-frequency musculoskeletal ultrasound is a better investigation in the postoperative follow up to find out tendon adhesions and rupture and most importantly dynamic assessment.

Short-Term and Long-Term Therapeutic Results of Deep Flexor Tendon Repair in Zone II in Patients Referred To Imam Khomeini Hospital, Ahvaz, Southern Iran

“…In Tabriz, Iran, the range of motion was assessed by Strickland classification, and the results were as follows: 78.3% excellent, 10% good, 5% moderate and 6.7% bad, and there was no significant difference between the results in men and women and in immediate and delayed primary repair 24 . The range of motion was excellent and good in 71% of subjects, moderate in 34%, and bad in 15% of individuals 25 .…”

Early or delay? The most suitable rehabilitation protocol for “no man's land” injury: Meta-analysis with trial sequential analysis—20 years trends

“…When the hand surgeon fails to remake this anatomical relationship, it will restrain tendon to glide and increase the risk of adhesion and restrict the digital movement. 10,11…”

“…When the hand surgeon fails to remake this anatomical relationship, it will restrain tendon to glide and increase the risk of adhesion and restrict the digital movement. 10,11 In the middle of 1970s, Duran and Houser, 12 delineate their method which involved "controlled passive motion" and reported that the restrictive adhesions tendon may be prevented with 3 until 5 mm length of tendon excursions. Concomitantly, Kleinert et al 13 investigated the promising outcome using direct passive motion postsurgical with a rubber band as an orthosis to pull back the finger and permit active finger extension, with producing passive flexion movement of finger.…”

Precoce ou tardio? O protocolo de reabilitação mais adequado para lesão na região ‘terra de ninguém’: Metanálise com análise sequencial de ensaios – Tendências de 20 anos

“…When the hand surgeon fails to remake this anatomical relationship, it will restrain tendon to glide, increase the risk to adhesion and restrict the digital movement. 10 11 …”

“…Quando o cirurgião de mão não consegue refazer esta relação anatômica, ele restringirá o deslizamento do tendão, aumentará o risco de adesão e restringirá o movimento digital. 10 11 …”