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      The Pediatric Upper Extremity 

      Flexor Tendon Injuries

      Springer New York

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          Digital function following flexor tendon repair in Zone II: A comparison of immobilization and controlled passive motion techniques.

          The performance of 50 consecutive digits in 37 patients was analyzed following flexor tendon repair in Zone II. Twenty-five digits were managed by 3 1/2 weeks of immobilization followed by a program of gradually increased motion; 25 other digits by intermittent passive motion initiated within the first 5 days with active flexion commenced at 4 1/2 weeks. Results were graded according to the percentage of return of motion at the proximal and distal interphalangeal joints. There were four ruptures in the immobilization group with no excellent results, 12% being rated good, 28% fair, and 11% poor. In the digits managed by early mobilization there were 36% excellent, 20% good, 16% fair, 24% poor; there was one rupture in this group. Early passive motion appeared to be an effective technique to improve the results of flexor tendon repairs in this area.
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            Outcomes and evaluation of flexor tendon repair.

            This article reviews recent reports of outcomes of flexor tendon repair and discusses the problems associated with such surgeries. Reports of no repair rupture in individual case series have emerged recently. Their results move toward the clinical goal of primary repair without repair rupture. The Strickland method remains the most common to record the outcomes. Outcomes should be provided by subzones of the tendon injuries, and the level of expertise of the surgeons expertise should be reported to allow comparisons of the results.
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              Primary flexor tendon repair in zone 1.

              This paper presents an analysis of the results of repair of 102 complete flexor tendon disruptions in zone 1 which were rehabilitated by an early active mobilization technique during a 7 year period from 1992 to 1998. These injuries were subdivided into: distal tendon divisions requiring reinsertion; more proximal tendon divisions but still distal to the A4 pulley; tendon divisions under or just proximal to the A4 pulley; and closed avulsions of the flexor digitorum profundus tendon from the distal phalanx. Assessment by Strickland's original criteria showed good and excellent results of 64%, 60%, 55% and 67% respectively in the four groups. However, examination of the results measuring the range of movement of the distal interphalangeal (DIP) joint alone provided a more realistic assessment of the affect of this injury on DIP joint function, with good and excellent results of only 50%, 46%, 50% and 22% respectively in the four groups.

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                June 17 2014
                : 1-23


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