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: 1.67). 08/1987; 12(4):582-9. DOI: 10.1016/S0363-5023(87)80212-5
Source: PubMed


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.

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    ABSTRACT: We have attempted to review the development and current status of flexor tendon surgery. The methods of acute flexor tendon repair, conventional free tendon grafting, staged flexor tendon reconstruction, tenolysis and pulley restoration have been discussed, with the published results included for each procedure. The role of rehabilitation has also been reviewed and the ongoing quest for an active flexor tendon prosthetic implant has been briefly mentioned. It may be seen that flexor tendon surgery is a complex and difficult art which requires a thorough appreciation of the normal flexor tendon system, the exact status of that system following injury and surgery and a strong understanding of the techniques which may be best utilised to restore tendon gliding and digital joint motion. The procedures described require both technical skill and experience and the post-operative therapy programmes must be carefully chosen for each patient. With the important laboratory and clinical advancements occurring in many areas of flexor tendon surgery, it is realistic to believe that in the future the techniques described here will be substantially altered and modified and to hope that results will continue to improve until the patient and surgeon can expect to restore most digits to nearly full function after flexor tendon interruption.
    No preview · Article · Dec 1989 · The Journal of Hand Surgery British & European Volume
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    No preview · Article · Dec 1989 · The Journal of Hand Surgery British & European Volume
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    No preview · Article · Mar 1990 · Journal of Orthopaedic Research
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