scholarly journals Silicone Foley’s catheter as an effective alternative to Hunter’s rod in staged flexor tendon reconstruction of the hand

2016 ◽  
Vol 49 (03) ◽  
pp. 322-328 ◽  
Author(s):  
Tawheed Ahmad ◽  
Sheikh Adil Bashir ◽  
Mohammad Inam Zaroo ◽  
Adil Hafeez Wani ◽  
Saima Rashid ◽  
...  
Keyword(s):  
Flexor Tendon ◽  
Tendon Repair ◽  
Treatment Method ◽  
Effective Alternative ◽  
Reconstruction Procedure ◽  
Active Motion ◽  
Tendon Reconstruction ◽  
Total Active Motion ◽  
Zone Ii ◽  
Foley’S Catheter

ABSTRACT Context: Staged flexor tendon reconstruction is most suitable treatment method for extensive zone II tendon injuries. The Hunter’s rod used in this procedure is costly and not easily available, which adds to the miseries of both patients as well as treating surgeon. Aims: The aim of this study is to evaluate the results of staged zone II flexor tendon repair using silicone Foley’s catheter as a cheaper and readily available alternative to Hunter’s rod. Settings and Design: This was a prospective study. Materials and Methods: Seventy digits in 35 patients were treated by the staged flexor tendon reconstruction using silicone Foley’s catheter in place of Hunter’s rod, and the patients were followed for an average period of 18 months. Early controlled motion exercise protocol was instituted in all cases. Results: As per the Strickland scale, total active motion obtained was excellent in 70%, good in 20%, fair in 7.1% and poor in 2.9% of patients. Conclusions: Silicone Foley’s catheter is cheaper, easily available and an effective alternative to Hunter’s rod in staged flexor tendon reconstruction procedure, yielding high rates of excellent and good results with fewer complications.

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.

Is there a correlation between patient-reported outcome assessed by the Disabilities of the Arm, Shoulder and Hand Questionnaire and total active motion after flexor tendon repair?

Hand Therapy ◽  
2012 ◽  
Vol 17 (2) ◽  
pp. 37-41 ◽  
Author(s):  
Paola Errera Magnani ◽  
Aline Miranda Ferreira ◽  
Eula Katucha da Silva Rodrigues ◽  
Rafael Inácio Barbosa ◽  
Nilton Mazzer ◽  
...  
Keyword(s):  
Flexor Tendon ◽  
Tendon Repair ◽  
Patient Reported Outcome ◽  
Flexor Tendon Repair ◽  
Active Motion ◽  
Patient Reported ◽  
Total Active Motion

Clinical outcomes of early active mobilization following flexor tendon repair using the six-strand technique: short- and long-term evaluations

2014 ◽  
Vol 40 (3) ◽  
pp. 250-258 ◽  
Author(s):  
K. Moriya ◽  
T. Yoshizu ◽  
Y. Maki ◽  
N. Tsubokawa ◽  
H. Narisawa ◽  
...  
Keyword(s):  
Flexor Tendon ◽  
Tendon Repair ◽  
Flexor Digitorum Superficialis ◽  
Flexor Tendon Repair ◽  
Active Motion ◽  
Total Active Motion ◽  
Active Mobilization ◽  
Flexor Digitorum

We evaluated the factors influencing outcomes of flexor tendon repair in 112 fingers using a six-strand suture with the Yoshizu #1 technique and early postoperative active mobilization in 101 consecutive patients. A total of 32 fingers had injuries in Zone I, 78 in Zone II, and two in Zone III. The mean follow-up period was 6 months; 16 patients (19 fingers) participated in long-term follow-up of 2 to 16 years. The total active motion was 230° SD 29°; it correlated negatively with age. The total active motion was 231° SD 28° after repair of the lacerated flexor digitorum superficialis tendon, and was 205° SD 37° after excision of the flexor digitorum superficialis tendon ends ( p = 0.0093). A total of 19 fingers showed no significant increases in total active motion more than 2 years after surgery. The rupture rate was 5.4% in our patients and related to surgeons’ level of expertise. Five out of six ruptured tendons were repaired by inexperienced surgeons. Level of Evidence IV

Efficacy of Adcon-T/N After Primary Flexor Tendon Repair in Zone II: A Controlled Clinical Trial

2003 ◽  
Vol 28 (2) ◽  
pp. 113-115 ◽  
Author(s):  
A. GOLASH ◽  
A. KAY ◽  
J. G. WARNER ◽  
F. PECK ◽  
J. S. WATSON ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Flexor Tendon ◽  
Tendon Repair ◽  
Tendon Sheath ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Flexor Tendon Repair ◽  
Double Blind ◽  
Active Motion ◽  
Zone Ii

A prospective double-blind, randomized, controlled clinical trial was conducted to assess the use of ADCON-T/N after flexor tendon repair in Zone II. Forty-five patients with 82 flexor tendon repairs in 50 digits completed the study. ADCON-T/N was injected into the tendon sheath after tenorrhaphy in the experimental group while the control group was not treated with ADCON-T/N. ADCON-T/N had no statistically significant effect on total active motion at 3, 6 and 12 months but the time taken to achieve the final range of motion was significantly shorter in treated patients. ADCON-treated patients had a higher rupture rate but this was not significant.

Outcomes of grafting intrasynovial tendons of the toes to the hands in 10 patients: a preliminary report

2017 ◽  
Vol 42 (5) ◽  
pp. 469-472 ◽  
Author(s):  
H. Ohi ◽  
S. Uchiyama ◽  
T. Kanda ◽  
M. Mukoda ◽  
M. Hayashi ◽  
...  
Keyword(s):  
Complication Rate ◽  
Preliminary Report ◽  
Flexor Tendon ◽  
High Complication Rate ◽  
Level Of Evidence ◽  
Active Motion ◽  
Tendon Reconstruction ◽  
Total Active Motion ◽  
Distal Interphalangeal

Ten patients had intrasynovial tendon grafting harvested from the toes for secondary flexor tendon reconstruction in nine fingers and one thumb in our institutes from 2009 to 2014. These patients were followed for a mean of 15 (range: 8–36) months. The ranges of total active motion of the proximal and distal interphalangeal joints of these nine fingers were 143° (range: 108–175°) and of the metacarpophalangeal and interphalangeal joints of one thumb were 110°. In conclusion, this technique is feasible and gives a good result when successful but with a high complication rate. Level of Evidence IV

Outcomes of flexor tendon repairs in zone 2 subzones with early active mobilization

2017 ◽  
Vol 42 (9) ◽  
pp. 896-902 ◽  
Author(s):  
K. Moriya ◽  
T. Yoshizu ◽  
N. Tsubokawa ◽  
H. Narisawa ◽  
S. Matsuzawa ◽  
...  
Keyword(s):  
Flexor Tendon ◽  
Tendon Repair ◽  
Level Of Evidence ◽  
Active Motion ◽  
Risk Of Rupture ◽  
Total Active Motion ◽  
A2 Pulley ◽  
Active Mobilization ◽  
The Mean ◽  
Difficult Area

We report on the outcomes of flexor tendon repair in zone 2 subzones with early active mobilization in 102 fingers in 88 consecutive patients. There were 28, 53, 15, and six fingers with repairs in zones 2A to 2D, respectively. Rupture of the repair occurred in four fingers, all in zone 2B. Excluding those with repair ruptures, the mean total active motion was 230° (range 143°–286°). Evaluated with Tang’s criteria, the outcomes were ranked excellent in 39 fingers, good in 46, fair in ten, poor in three, and failure in four. The outcomes in zone 2C were significantly inferior to those in zones 2B and 2D ( p = 0.02). Our results suggest that the tendon laceration in the area covered by the A2 pulley (zone 2C) is the most difficult area to obtain satisfactory active digital motion and tendon repair in zone 2B is the area where the risk of rupture is highest. Level of evidence: IV

Flexor Subzone II A–D Range of Motion Progression during Healing on a No-Splint, No-Tenodesis Protection, Immediate Full Composite Extension Regimen

2019 ◽  
Vol 24 (04) ◽  
pp. 405-411
Author(s):  
Mark Henry ◽  
Forrest H. Lundy
Keyword(s):  
Flexor Tendon ◽  
Dash Score ◽  
Active Motion ◽  
Rehabilitation Protocol ◽  
Single Finger ◽  
Total Active Motion ◽  
Joint Flexion ◽  
Zone Ii ◽  
Therapy Protocol ◽  
High Range

Background: The objective was to study the hypotheses that an advanced zone II flexor tendon rehabilitation protocol would avoid rupture, achieve a high range of excursion, and minimize interphalangeal contracture during both the early phases and at the conclusion of healing. We also proposed the null hypothesis of no difference between any two of the zone II subdivisions. Methods: Fifty-one consecutive adult patients with zone II flexor tendon repairs of a single finger were retrospectively evaluated on an active contraction rehabilitation protocol with no splint, no tenodesis protection, and immediate full composite extension. There were 38 males and 13 females with a mean age of 39 years (range 18–69) involving 15 index, 7 long, 6 ring, and 23 small fingers. Repairs were located in flexor subzone IIA for 8 fingers; subzone IIB, 14; subzone IIC, 19; and subzone IID, 10. Differences in outcome between any two subzones were compared by T-test with p < 0.05. Results: Mean active arcs of motion in degrees at 3 weeks post repair were PIP 1-93; DIP 0-44; and total active motion (TAM) 221. At 6 weeks PIP 2–98; DIP 1–51; and TAM 236. At 10–12 weeks PIP 1–101; DIP 1–56; and TAM 246. Final TAM by flexor subzone IIA was 243; IIB, 251; IIC, 246; and IID, 246. There were no significant differences between any two subzones. Mean final DASH score was 5. There were no ruptures. Conclusions: The results support the hypotheses. Outcomes of the therapy protocol demonstrated the lack of interphalangeal joint flexion contractures, high range of total active motion achieved early and sustained, and no ruptures. No differences were identified between and two of the flexor subzones.

A PROSPECTIVE RANDOMIZED CONTROLLED TRIAL OF CONTROLLED PASSIVE MOBILIZATION VS. PLACE AND ACTIVE HOLD EXERCISES AFTER ZONE 2 FLEXOR TENDON REPAIR

Hand Surgery ◽  
2014 ◽  
Vol 19 (01) ◽  
pp. 53-59 ◽  
Author(s):  
Maryam Farzad ◽  
Fereydoun Layeghi ◽  
Ali Asgari ◽  
David C. Ring ◽  
Masoud Karimlou ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Flexor Tendon ◽  
Controlled Trial ◽  
Tendon Repair ◽  
Flexor Tendon Repair ◽  
Active Motion ◽  
Randomized Controlled ◽  
Prospective Randomized Controlled Trial ◽  
Total Active Motion ◽  
Passive Mobilization

Purpose: The rehabilitation program after flexor tendon repair of zone II laceration varies. We designed a Prospective Randomized Controlled Trial of controlled passive mobilization (modified Kleinert) vs. Place and active hold exercises after zone 2-flexor tendon repair by two-strand suture (Modified kessler). Methods: Sixty-four fingers in 54 patients with zone 2 flexor tendon modified Kessler repairs were enrolled in a prospective randomized controlled trial comparing place and active hold exercises to controlled passive mobilization (modified Kleinert). The primary outcome measure was total active motion eight weeks after repair as measured by an independent and blinded therapist. Results: Patients treated with place and active hold exercises had significantly greater total active motion (146) eight weeks after surgery than patients treated with controlled passive mobilization (114) (modified Klinert). There were no ruptures in either group. Conclusions: Place and hold achieves greater motion than controlled passive mobilization after a two-strand repair for zone 2 flexor tendon repairs.

scholarly journals Active Mobilisation after Flexor Tendon Repair: Comparison of Results following Injuries in Zone 2 and other Zones

2005 ◽  
Vol 13 (2) ◽  
pp. 158-163 ◽  
Author(s):  
LK Hung ◽  
KW Pang ◽  
PLC Yeung ◽  
L Cheung ◽  
JMW Wong ◽  
...  
Keyword(s):  
Flexor Tendon ◽  
Tendon Repair ◽  
Clinical Results ◽  
Range Of Movement ◽  
Flexor Tendon Repair ◽  
Active Motion ◽  
Day Range ◽  
Flexor Tendon Injuries ◽  
Total Active Motion ◽  
American Society

Purpose. To prospectively study the role of active mobilisation after flexor tendon repair. Methods. The standard modified Kessler's technique was used to repair 46 digits in 32 patients with flexor tendon injuries. Early active mobilisation of the repaired digit was commenced on the third postoperative day. Range of movement was monitored and recovery from injury in zone 2 was compared with injury in other zones. Results. There were 24 and 22 injuries in zone 2 and other zones respectively. The total active motion score of the American Society for Surgery of the Hand was measured. Patients with zone-2 injuries achieved similar results to those with other-zone injuries apart from a 3-week delay in recovery. The final results were good to excellent in 71% and 77% of zone-2 and other-zone cases respectively (p<0.05). There were 2 ruptures in zone-2 and one rupture in zone-3 repairs (6.5%). Conclusion. Preliminary results of this study showed that active mobilisation following flexor tendon repair provides comparable clinical results and is as safe as conventional mobilisation programmes although recovery in patients with zone-2 injury was delayed.

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