Article

An experimental flexor tendon repair in zone II that allows immediate postoperative mobilization.

Department of Orthopaedics, JHM Health Center, University of Florida, Gainesville, Fla.
The Journal Of Hand Surgery (Impact Factor: 1.57). 08/1987; 12(4):582-9. DOI: 10.1016/S0363-5023(87)80212-5
Source: PubMed

ABSTRACT An experimental method of approximating severed flexor tendons in zone II that allows immediate postoperative mobilization is described. The repair uses a nonabsorbable suture anchored into the severed tendon in zone III. This experimental repair was performed on one foot in each of 18 adult, white Leghorn chickens. The control side used the modified Kessler technique to repair the zone II laceration. The animals were prevented from weight-bearing activities but were allowed active motion of the foot for 5 to 6 weeks postoperatively. The results demonstrated a marked diminution in flexor tendon adhesions, with intrinsic tendon collagen formation serving to reconstitute tendon continuity on the experimental side. The breaking strengths of the two repair methods were equivalent. These results suggest that this method may allow primary repair of tendon injuries in zone II, with minimal formation of adhesions.

0 Bookmarks
 · 
98 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: It is beyond doubt that splinting programmes have often been an integral and important part of the rehabilitation process in tendon injuries. Over the past three decades, hand splints for tendon injuries of various designs and different mobilisation programmes have been developed in the hope of pursuing better clinical and functional outcome for patients. In this paper, the development of different splinting programmes in flexor and extensor tendon injuries and the current practice in some acute hospitals in Hong Kong were discussed.
    Hand Surgery 01/2003; 7(2):243-9.
  • [Show abstract] [Hide abstract]
    ABSTRACT: This study was designed to compare five different suture methods that are used clinically for tendon repair. The flexor digitorum profundus tendons from the digits of adult mongrel dogs and adult human cadavers were used as models. The tendons in zone II of the hand, defined as the region from the distal palmar crease to the insertion of the flexor digitorum superficialis tendon at the middle phalanx, were transected and then were repaired by one of the suture methods developed by Kessler, Tsuge, Tajima, Savage, or Lee. The gliding function and tensile properties of the repaired tendons were evaluated biomechanically at time zero. The Tajima and Savage methods produced better gliding function than the other techniques. In the canine specimens that had been repaired by one of these two methods, the rotation of the distal interphalangeal joint was more than 60% of the rotation of the canine control specimens; only the Savage technique produced a rotation 124% that of the human control specimens. After the Tajima repair, the rotation of the proximal interphalangeal joint was 113% that of the canine control specimens and 157% that of the human controls. In the canine specimens that had had the Tajima or Savage repair, excursion of the tendon was greater than 55% that of the controls. The tendons repaired by the Savage method tolerated a significantly higher ultimate load to failure (14 and 25% that of the canine and human control specimens, respectively) than the other methods.(ABSTRACT TRUNCATED AT 250 WORDS)
    Journal of Orthopaedic Research 08/1993; 11(4):603-11. · 2.88 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To prospectively study the role of active mobilisation after flexor tendon repair. 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. 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%). 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.
    Journal of orthopaedic surgery (Hong Kong) 08/2005; 13(2):158-63.