The Effects of a Shortened Postoperative Mobilization Programme after Flexor Tendon Repair in Zone 2

1996 ◽  
Vol 21 (1) ◽  
pp. 67-71 ◽  
Author(s):  
L. ADOLFSSON ◽  
G. SÖDERBERG ◽  
M. LARSSON ◽  
L-E. KARLANDER
Keyword(s):  
Grip Strength ◽  
Flexor Tendon ◽  
Tendon Repair ◽  
Functional Results ◽  
Subjective Assessment ◽  
Flexor Tendon Repair ◽  
Full Activity ◽  
Increased Risk ◽  
Risk Of Rupture ◽  
Absence From Work

The effects of a shortened post-operative mobilization programme following flexor tendon repair in zone 2 in the hand were examined in a prospective, randomized study. 91 digits in 82 patients were included in the study. All injured tendons were repaired within 24 hours and all patients were subjected to the same mobilization programme during the first 6 weeks using a passive flexionactive extension régime. After 6 weeks the patients were randomized into two groups; in group A full activity was allowed after 8 weeks while in group B unrestricted use of the injured hand was not allowed until 10 weeks after the tendon repair. Functional results were compared using the Louisville, Tsuge and Buck-Gramcko assessment systems. Grip-strength was measured 16 weeks after repair, subjective assessment of hand function was recorded on a visual analogue scale, and absence from work was registered. No significant differences were observed between the groups regarding functional results, rupture rates, grip strength or subjective assessment, but absence from work was reduced by 2.1 weeks with the shorter mobilization programme. Using the described régime, full activity can be encouraged 8 weeks after flexor tendon repair in zone 2 of the hand without adverse effects on functional results or increased risk of rupture of the repair.

Methods of Evaluation of the Functional Results of Flexor Tendon Repair of the Fingers

1985 ◽  
Vol 10 (1) ◽  
pp. 60-61 ◽  
Author(s):  
A. B. NIELSEN ◽  
P. Ø. JENSEN
Keyword(s):  
Functional Outcome ◽  
Standard Method ◽  
Flexor Tendon ◽  
Tendon Repair ◽  
Functional Results ◽  
Functional Evaluation ◽  
Flexor Tendon Repair ◽  
Methods Of Evaluation ◽  
Method Of Measurement ◽  
No Man's Land

The methods used by Buck-Gramcko, Kleinert and Tsuge in evaluating the functional results of flexor tendon repair were each applied to assess the functional outcome in sixty-seven fingers where both tendons had been severed in “no man's land”. The method of Buck-Gramcko gave the highest rating, and the three methods showed evident differences in the results of evaluation after surgery. The study suggests a need for one standard method of measurement and recording, if a comparison of results after flexor tendon repair is to be of value. We found that the method of Buck-Gramcko incorporated the most essential features in the functional evaluation.

The Effect of Delay to Surgery on Major Complications after Primary Flexor Tendon Repair

2019 ◽  
Vol 24 (02) ◽  
pp. 161-168 ◽  
Author(s):  
Aleksi Reito ◽  
Mari Manninen ◽  
Teemu Karjalainen
Keyword(s):  
Flexor Tendon ◽  
Multivariable Analysis ◽  
Tendon Repair ◽  
Significant Risk ◽  
Mechanism Of Injury ◽  
Flexor Tendon Repair ◽  
Major Complications ◽  
Increased Risk ◽  
Early Passive ◽  
Surgery Delay

Background: Flexor tendon repair carries a significant risk for complications, which often leads to revision surgery. The purpose of this study was to assess the effect of different factors on the risk for major complications patients undergoing a primary end-to-end flexor tendon repair and early passive mobilization regimen (Kleinert protocol). Methods: Between January 2000 and September 2009, a total of 312 patients underwent a flexor tendon repair at out institution. We excluded patients whose injury was self-inflicted or secondary to a rheumatic disease or a fall leaving 187 patients with 325 injured tendons for the study. Results: 152 (81.7%) patients were male and 34 (18.3%) females. Mean age of the patients was 32.7 years (SD 14.4, range 11 to 73). The fifth ray was most commonly affected. The majority of the injuries were located in zone II. Median delay to surgery was 3 days. Complications were observed in 34 patients (18.2%). Univariable analysis showed that patient age, mechanism of injury, injured ray, delay to surgery between three and seven days, and greater suture thickness were associated with increased risk of complications. In the subsequent multivariable analysis, only the mechanism of injury and delay to surgery remained as significant risk factors for major complications. Conclusions: We conclude that complications after flexor tendon repair may be reduced by appropriate timing of the surgery. Delay to surgery lasting between three and seven days seems to be associated with increased risk for major complications.

Autonomous Patient-Controlled Mobilization Protocol After Flexor Tendon Repair: A Case Series

Hand ◽  
2020 ◽  
pp. 155894472096496
Author(s):  
Bárbara Gómez ◽  
María Rodríguez ◽  
Luis García
Keyword(s):  
Range Of Motion ◽  
Grip Strength ◽  
Flexor Tendon ◽  
Tendon Repair ◽  
Case Series ◽  
Flexor Tendon Repair ◽  
Active Motion ◽  
Early Return ◽  
The Mean

Background: Despite many publications on rehabilitation after repair of flexor tendon injuries of the hand, there is no consensus as to which method is superior. It is clear that nonadherence to postoperative therapy adversely affects the outcome after flexor tendon surgery. In the context of a developing country, the most important factor associated with poor outcome is late onset of rehabilitation therapy. An autonomous rehabilitation program is proposed, with the use of a low-cost splint and based on an online illustrative video with the expectation to improve adherence and patient compliance, thus ensuring satisfactory outcome. Methods: Twenty-two consecutive digits of 14 patients after flexor tendon repair in zone II were included. Autonomous early passive mobilization physical therapy and splinting started shortly after surgery, supported by an online available video depicting prescribed exercises; follow-up was continued until postoperative week 20. Patients were evaluated regarding range of motion, grip strength, and the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) disability scale. Results: Range of motion after 20 weeks according to the scoring system of the American Society of Surgery of Hand was excellent in 4, good in 11, and fair in 4 fingers. The mean total active motion score was 86% (95% confidence interval, 78%-93%). The mean grip strength at final follow-up was 86% of the contralateral hand. The mean QuickDASH score was 12.5 (2.3-31.8). Conclusion: This protocol achieves good results in range of motion and early return of function of the hand. We propose this simple, nonexpensive method to developing countries with less than optimal availability of health care.

Reduction of Grip Strength, Finger Flexion Pressure, Finger Pinch Pressure and Key Pinch Following Flexor Tendon Repair

1987 ◽  
Vol 12 (2) ◽  
pp. 182-184
Author(s):  
D. T. GAULT
Keyword(s):  
Grip Strength ◽  
Flexor Tendon ◽  
Tendon Repair ◽  
Flexor Pollicis Longus ◽  
Flexor Tendon Repair ◽  
Flexor Tendons ◽  
Finger Flexion

67 patients with 176 repaired flexor tendons have been reviewed after a mean follow-up interval of 26.4 months. After repair, mean grip strength was 74.5%, mean finger flexion pressure 76.8% and mean finger pinch pressure 74.7% of that of the opposite uninjured hand or digit. For 16 patients with repaired flexor pollicis longus tendons, mean key pinch was 78.7%. Grip strength was reduced after injury to tendons alone, but was especially reduced when there was concomitant damage to the median or ulnar nerves.

scholarly journals Influence of Pulsed Magnetic Field Therapy on Hand Function Post Flexor Tendon Repair: A Randomized Controlled Trial

2021 ◽  
Author(s):  
Rania Reda Mohamed ◽  
Hamada Hamada ◽  
Eman M. Othman ◽  
Abdullah M. Al-Shenqiti ◽  
Noha Elserty
Keyword(s):  
Grip Strength ◽  
Flexor Tendon ◽  
Hand Function ◽  
Tendon Repair ◽  
Flexor Tendon Repair ◽  
Pinch Grip ◽  
Hand Grip ◽  
Magnetic Field Therapy ◽  
Significant Difference ◽  
Field Therapy

IntroductionPurpose: The study was conducted to investigate the influence of pulsed magnetic field therapy on hand function, grip and pinch grip strength in post flexor tendon repair patients.Material and methodsMethods: Fifty male patients with flexor tendon repair took part in this research, with ages ranging from 25 to 50 years. They were assigned randomly into two groups: Group A (experimental) received pulsed magnetic therapy together with exercise, whereas Group B (control) received only exercise. Evaluation of hand grip strength with Jamar hydraulic hand dynamometer, pinch strength with Baseline pinch gauge and hand function with Michigan Hand Outcomes Questionnaire, all measurements were made before and after the treatment. They were received 16 sessions for 8 weeks (2 sessions/week).ResultsResults: 2 x2 mixed design MANOVA revealed that no significant difference between both groups pre- treatment and post treatment in MHOQ total, function, aesthetic (p>0.05) and in hand grip strength while there was a significant difference across groups after treatment in the strength of pinch grip, MHOQ ADL, pain and satisfaction p <0.05), there was also a significant difference between pre- and post-treatment within groups in all outcome measures. (p <0.05).ConclusionsConclusion: PMF increases the efficiency of physical therapy treatment and it also increases the strength of both hand grip and pinches grip in patients after flexor tendon repair in zone II.

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

2008 ◽  
Vol 33 (4) ◽  
pp. 418-423 ◽  
Author(s):  
G. L. Hoffmann ◽  
U. Büchler ◽  
E. Vögelin
Keyword(s):  
Flexor Tendon ◽  
Tendon Repair ◽  
Functional Results ◽  
Clinical Results ◽  
Rubber Band ◽  
Flexor Tendon Repair ◽  
Active Motion ◽  
Flexor Tendon Injuries ◽  
Total Active Motion ◽  
Zone Ii

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° compared with 123°. 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.

scholarly journals Rupture Rate, Functional Outcome and Patient Satisfaction after Primary Flexor Tendon Repair with the Modified 4-Strand Core Suture Technique by Tsuge and Using the Arthrex FiberLoop® with Early Motion Rehabilitation

2021 ◽  
Vol 10 (19) ◽  
pp. 4538
Author(s):  
Stephanie Vanessa Koehler ◽  
Michael Sauerbier ◽  
Athanasios Terzis
Keyword(s):  
Patient Satisfaction ◽  
Functional Outcome ◽  
Grip Strength ◽  
Flexor Tendon ◽  
Tendon Repair ◽  
Suture Technique ◽  
Dash Score ◽  
Flexor Tendon Repair ◽  
Rupture Rate ◽  
The Mean

Purpose:Our hypothesis was that the rupture rate after primary flexor tendon repair in the modified 4-strand core suture technique using the FiberLoop® (Arthrex, Munich, Germany) is lower than in other suture materials and functional outcome and patient satisfaction are superior compared to the current literature. Patients and methods: A 2-stage retrospective, randomized follow-up study of 143 patients treated with the Arthrex FiberLoop® after flexor tendon injury in zones 2 or 3 from May 2013 to May 2017 was performed. In the 1st stage, the rupture rate of all patients was assessed after a follow-up of at least one year by interview to exclude revision surgery. In the 2nd stage, 20% of the patients could be randomly clinically examined. Functional parameters, such as finger and wrist range of motion measured by goniometer, grip strength measured by Jamar dynamometer (Saehan, South Korea), patient satisfaction measured by school grades (1–6), pain levels measured by visual rating scales (0–10) and functional outcome according to the DASH-score were assessed. The Buck-Gramcko and Strickland scores were calculated. The length of sick leave was recorded. Results: A rupture rate of 2.1% was recorded. 29 patients (20%) were followed up at a mean of 34 ± 7.5 months postoperatively. 10.3% of these patients had an incomplete fingertip palm distance. The mean postoperative grip strength was 24 ± 3.1 kg. 93% of the patients were very satisfied with the treatment. No patient complained of pain postoperatively. The mean postoperative DASH score was 6.7 ± 2.8 points. The mean Buck-Gramcko score was 14 ± 0.2 points. 93% of the patients had excellent and 7% good results according to the Strickland score. 67% of patients had a work accident and returned to work at a mean of 4 ± 0.2 months postoperatively. 31% of patients suffered a non-occupational injury and returned to work at a mean of 3 ± 0.4 months postoperatively. Conclusions: Primary flexor tendon repair in the modified 4-strand core suture technique using the Arthrex FiberLoop® has proven to be a viable treatment option in our series. The rupture rate was lower than in other suture materials. It leads to acceptable pain relief, grip strength and functional outcome. Level of Evidence: IV; therapeutic.

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