22 Flexor Tendon Repair in Zone 2: Prevention and Management of Complications by Hand Therapy

The clinical and hand therapy notes of 180 patients who had single digit flexor tendon repairs in zones I and II from January 2000 to December 2004 were reviewed. Data from 60 index and 108 little fingers at 5 weeks, 8 weeks and 12 weeks follow-up visits were included. In zone I injuries, there was a statistically significant difference in flexion contracture (worse in the little fingers ) at all follow-up points. Although the range of motion and percentage of patients in the excellent category of the Strickland and Glogovac criteria were greater in the index finger group than the little finger for zone I and II injuries, these differences were not statistically significant. The rupture rate was also higher in the little finger group.

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Effect of Time to Hand Therapy following Zone II Flexor Tendon Repair

Plastic & Reconstructive Surgery Global Open ◽

10.1097/gox.0000000000003278 ◽

2020 ◽

Vol 8 (12) ◽

pp. e3278

Author(s):

Shepard P. Johnson ◽

Brian P. Kelley ◽

Jennifer F. Waljee ◽

Kevin C. Chung

Keyword(s):

Flexor Tendon ◽

Tendon Repair ◽

Hand Therapy ◽

Flexor Tendon Repair ◽

Zone Ii

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Early Results of Flexor Tendon Repair in Zone II With Modified, Four-Strand Strickland Technique

Polish Journal of Surgery ◽

10.2478/v10035-008-0100-8 ◽

2008 ◽

Vol 80 (12) ◽

Author(s):

Ireneusz Walaszek ◽

Andrzej Żyluk ◽

Bernard Piotuch

Keyword(s):

Flexor Tendon ◽

Tendon Repair ◽

Flexor Tendon Repair ◽

Early Results ◽

Zone Ii

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Ischaemic contracture of the hand

Indian Journal of Plastic Surgery ◽

10.1055/s-0039-1699134 ◽

2006 ◽

Vol 39 (01) ◽

pp. 94-102

Author(s):

G. Balakrishnan

Keyword(s):

Suture Material ◽

Flexor Tendon ◽

Tendon Repair ◽

Hypodermic Needle ◽

Flexor Tendon Repair ◽

Active Motion ◽

Custom Made

ABSTRACTStronger flexor tendon repairs facilitate early active motion therapy protocols. Core sutures using looped suture material provide 1 ½ to twice the strength of Kessler′s technique (with four strand and six strand Tsuge technique respectively). The technique is well-described and uses preformed looped sutures (supramid). This is not available in many countries and we describe a technique whereby looped sutures can be introduced in flexor tendon repair by the use of 23 G hypodermic needle and conventional 4.0 or 5.0 sutures. This is an alternative when the custom made preformed sutures are not available. This can be practiced in zone 3 to zone 5 repairs. Technical difficulties limit its use in zone 2 repairs.

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Comparison of the Outcomes of 2 Rehabilitation Protocols After Flexor Tendon Repair of the Hand at Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa

Hand ◽

10.1177/1558944716660555js ◽

2016 ◽

Vol 11 (1_suppl) ◽

pp. 139S-139S

Author(s):

Roxanne Wentzel ◽

Corrianne van Velze ◽

Elsje Rudman

Keyword(s):

South Africa ◽

Flexor Tendon ◽

Tendon Repair ◽

Academic Hospital ◽

Flexor Tendon Repair ◽

Rehabilitation Protocols

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

Journal of Hand Surgery (European Volume) ◽

10.1016/s0266-7681(85)80018-8 ◽

1985 ◽

Vol 10 (1) ◽

pp. 60-61 ◽

Cited By ~ 11

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.

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Looped suture properties: implications for multistranded flexor tendon repair

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193413516245 ◽

2015 ◽

Vol 40 (3) ◽

pp. 234-238 ◽

Cited By ~ 6

Author(s):

R. Haddad ◽

T. Peltz ◽

N. Bertollo ◽

W. R. Walsh ◽

S. Nicklin

Keyword(s):

Mechanical Properties ◽

Flexor Tendon ◽

Tendon Repair ◽

Relative Effect ◽

Flexor Tendon Repair ◽

Polypropylene Monofilament ◽

Single Suture ◽

Biomechanical Strength ◽

Standard Techniques ◽

Repair Techniques

Multiple-strand repair techniques are commonly used to repair cut flexor tendons to achieve initial biomechanical strength. Looped sutures achieve multiple strands with fewer passes and less technical complexity. Their biomechanical performance in comparison with an equivalent repair using a single-stranded suture is uncertain. This study examined the mechanical properties of double-stranded loops of 3-0 and 4-0 braided polyester (Ticron) and polypropylene monofilament (Prolene). Double loops were generally less than twice the strength of a single loop. Ticron and Prolene had the same strengths, but Ticron was stiffer. The 4-0 double loops had significantly higher stiffness than 3-0 single loops. Increasing the size of sutures had a larger relative effect on strength than using a double-stranded suture. However, a double-strand loop had a larger effect on increasing stiffness than using a single suture of a larger equivalent size. Looped suture repairs should be compared with standard techniques using a thicker single suture.

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